Membership Dues

New or Renewal of Membership (BY CREDIT CARD)

If paying by check to please print the email confirmation you receive and Mail with a check to the TESA Central office.

Prices reflect membership fee plus $5.00 credit/debit card fee.

2023-2024 Membership

Credit/Debit Card Fee

Credit Card Fee - $ 5.00

(If mailing a check or money order, please uncheck Credit Card Fee box above.)

Total Amount

Membership Application

First Name *

Middle Name

Last Name *

Street Address
(Primary) *

Address 1 (Primary)

City (Primary) *

State (Primary) *

Zip Code (Primary) *

Phone and
Extension (Work) *

Phone (Home)

Mobile

Email (Primary) *

Email (Secondary)

Current Employer *

Service Type *

Name of Local
TESA Affiliate

Referred By

Member of NAEOP *

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *