DON'T JUST SIT THERE!

IT'S TIME TO JOIN THE

TEXAS COMMUNITY COLLEGE TEACHERS ASSOCIATION!

(Please check the appropriate box or boxes)

P PAYMENT THROUGH PAYROLL DEDUCTION

“ Professional Membership (Faculty and Administrators) at $35

I, the undersigned, authorize Amarillo College to deduct $17.50 from my paycheck on October 31, 2006 and on November 30, 2006 and to remit said $35 to TCCTA for my dues for a Professional membership for 2006-2007.

“ Associate Membership (Classified Employees) at $25

I, the undersigned, am a monthly paid classified employee and authorize Amarillo College to deduct $12.50 from my paycheck on October 31, 2006 and on November 30, 2005 and remit said $25 to TCCTA for an Associate membership for 2006-2007. If you are a biweekly paid classified employee, $12.50 will be deducted from two pay periods during October 2006.

“ Professional Liability Insurance (coverage of $2,000,000) at $50

I, the undersigned, authorize Amarillo College to deduct $25.00 from my paycheck on October 31, 2006 and on November 30, 2006 and to remit said $50 to TCCTA for my Professional Liability Insurance (2005-2006). There are no forms to fill out. Available to all employees. You must be a member to obtain the insurance.

P PAYMENT BY CHECK

“ Professional Membership (Faculty & Administrators) for 2006-2007.

My CHECK for $35 TCCTA membership is attached. There are no forms to fill out.

[Make check payable to TCCTA]

“ Associate Membership (Classified Employees & Board Members) for 2006-2007.

My CHECK for $25 TCCTA membership is attached. There are no forms to fill out.

[Make check payable to TCCTA]

“ Professional Liability Insurance (coverage of $2,000,000) for 2006-2007.

My CHECK for $50 for professional liability insurance is attached. If you pay by check for both the dues and the professional liability insurance, you may write a SINGLE CHECK payable to TCCTA. There are no forms to fill out. Available to all employees.

You must be a member to obtain the insurance.

P PAYMENT BY CREDIT CARD

You may pay your ( “ dues); ( “ insurance); or ( “ both) by Visa or MasterCard.

“ VISA “ MC Credit card number

Expiration date / . If you elect this option, please route to Bob Sloger.

___________________________

Signature Please Print Your Name

_____________ ________________

Social Security Number (provide only if you payroll deduct) Date Department/Area

Return this form [and check, if payment is by check] to: Bob Sloger, Bill Crawford, Mark Hanna, David Hernandez, Pat Knight, Patsy Lemaster, Danita McAnally, Jack Stanley or Henry Wyckoff