Convert Payment Method To Payroll Deduction

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This form allows current ACOE members to convert their payment method to Payroll Deduction. ACOE will use the information we gathered from you when you joined to pre-fill a payroll deduction form. ACOE will mail the form to your school district payroll department. Your school district payroll department will setup your payroll deductions. Your membership dues will not increase.

How do you currently pay your ACOE membership dues:*

Bank Draft
PayPal
Debit Card
VISA
MasterCard
Personal Check
Payroll Deduction, but moving to a different district

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Choose your school system:*

IMPORTANT: ONLY school districts offering payroll deduction are shown on the drop-down list.

IMPORTANT: Jacksonville City School System does not allow employees to convert their payment method to payroll deduction after September 5th.

Choose your school district:*

IMPORTANT: ONLY school districts offering payroll deduction are shown on the drop-down list.

Email Address ACOE has on file.*

This helps ACOE identify you.

Email Address where you want your verification sent.

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School District Not Found

If your work location was not found, enter it in the space provided. Please enter the complete name.

BALDWIN COUNTY: When converting your dues payment method to payroll deduction, ACOE will handle all communications with your school district payroll department and setup monthly payroll deductions for you.

	Why use Payroll Deduction:
►	Payroll Deduction: Allows dues to be taken out of your payroll check by your school district and automatically renews each year without any action necessary on your part unless you change school districts or cancel your dues during the open enrollment period. If you change school districts, you will need to complete a new payroll deduction form for your new district (if available in that district) or select another payment option. Contact membership@ACOE.us with any questions you may have.

Why use Payroll Deduction:

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Payroll Deduction: Allows dues to be taken out of your payroll check by your school district and automatically renews each year without any action necessary on your part unless you change school districts or cancel your dues during the open enrollment period.

If you change school districts, you will need to complete a new payroll deduction form for your new district (if available in that district) or select another payment option. Contact membership@ACOE.us with any questions you may have.

Social Security Number*

Your school system requires your full Social Security Number for payroll deduction. Please enter your full SSN.

Payroll Deduction Signature

(This signature will be used to start your monthly payroll deductions.) Please sign in the signature box below. You can use your mouse or touch screen to write in the box.

Read Full Agreement

FULL AGREEMENT: By signing below, I authorize my employer to deduct annual professional membership dues as established annually from my salary according to terms set forth by mutual consent for this membership year and every year thereafter. This authorization may be canceled for a succeeding membership year by providing written notice to that effect to the association’s state headquarters and to my employer’s payroll administrator on or before September 15th of that year (earlier in some systems). If employment is terminated, member dues still owing under this authorization shall be deducted from my final pay as set forth in SECTION 16-22-6 of the Code of Alabama.

Signature*

** Please sign across the middle of the signature box.**

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Social Security Number Information

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SSN Last 4*

The last four numbers of your SSN are needed to start your payroll deduction.

ACOE / Member Agreement

By checking the “I understand” box below, you are stating that you understand:

1. Your ACOE membership dues payment method will be changed to Payroll Deduction.

(Monthly dues options are not available to Student Teachers.)

2. ACOE will submit required information to your school district payroll department so

Payroll Deduction can be started.

Please acknowledge:*

I understand

Comments

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