Associate Membership / Authorization Form

An associate member is a surviving spouse / partner of a retired teacher

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Name

Address

Town / City

Postal Code

Phone #

Email

Branch To Which I Prefer to Belong Annapolis Halifax CPX Pictou Antigonish/Guysborough Halifax City Queens AERBaie SainteMarie (Clare) Halifax County Richmond Colchester East Hants Inverness Shelburne Cumberland Kings Sydney & Area Dartmouth Lunenburg West Hants Digby New Waterford Yarmouth/Argyle Glace Bay & Area Northside Victoria Out of Province

Name of Deceased Spouse / Partner

Professional # of Spouse/Partner:

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Payment

I hereby authorize the monthly approved RTO membership fee deduction from the Nova Scotia Teachers Pension (presently $3/month). I can stop this deduction at anytime by returning my card to the RTO. *A temporary card may be issued with the permanent card to follow.

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Newsletter

Please check this box if you prefer to receive The Retired Teacher newsletter by email instead of regular mail.

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Associate members have the full rights, privileges and responsibilities of membership except in matters of voting and holding office of the Organization and are entitled to all the rights and privileges accorded to active members such as:
-Deals and Discounts
-Travel Club
-Home & Auto Insurance
-Health (Medavie / Blue Cross)
Please check our web site at http://rto.nstu.ca for additional information or call 1-800-565-6788 or 477-5621 in the Metro area.

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If the form does not work properly on your computer, click here for the printable PDF version of the form