New Members’ Application Requirement Guide

All applicants to Edir should apply in person, husband and wife if married,
at the in-person Board meeting.

If the Board meeting is held virtually, the applicant, both husband and wife
if married, must appear at the virtual meeting.

Applicants must provide all applicable supporting documents requested by EEMAA.
Supporting documents will be submitted separately according to instructions
provided by EEMAA after the online application is received.

2

Supporting Documents

Supporting documents are not uploaded through this public online form.
EEMAA will provide instructions after submission regarding how the applicable
documents should be provided.

Proof of Residency / Identification

Driver’s License, City ID, or other acceptable identification showing
the applicant’s Tri-State residence.

Birth Certificate – Applicant Age 22–35

Required when the applicant is applying under the 22–35 membership category.

Marriage Certificate

Required where applicable for married applicants in accordance with
EEMAA membership requirements.

Proof of Age – Dependent Children Under 22

Birth certificate or other acceptable proof of age is required for each
dependent child under 22 included in the application.

Important:
Please do not send sensitive documents through this public form.
EEMAA will provide document-submission instructions after the application
has been received.

3

Dues & Fees

Applicable One-time Membership Fee
*

Number of Dependent Parents

Annual Administrative Fee

Fee Schedule:

$1,000 one-time membership fee for couples and individuals over 35 years;
$250 one-time membership fee for applicants aged 22–35;
$500 for each dependent parent;
$75 for each dependent under 22;
plus the $50 annual administrative fee.

The final amount is calculated automatically.
When Stripe payment is enabled, the applicant will proceed to
Stripe’s secure payment page immediately after submitting this application.

4

Application for Membership

Applicant Full Name
*

Marital Status
*

5

Permanent Residence Address

Address Line 1
*

City
*

State
*

Zip Code
*

6

Contact Details

Home Phone

Cell Phone
*

Email
*

7

Spouse Details

If married, please provide the spouse’s full name, cell phone number,
and email address.

If not married, this section may be left blank.

If Married, Full Name of Spouse

Spouse’s Cell Phone

Spouse’s Email

8

Children Under 22 Years of Age

Please provide the names and dates of birth of dependent children
under 22 years of age.

Proof of age will be required separately for each dependent child listed.
Each dependent child under 22 is subject to the applicable $75 fee.

Child 1 Name

Child 1 Date of Birth

Child 2 Name

Child 2 Date of Birth

Child 3 Name

Child 3 Date of Birth

Child 4 Name

Child 4 Date of Birth

9

Death Beneficiary

If your spouse is your death beneficiary, select the option below.
This designation will work for either spouse.

My spouse is my death beneficiary

If your spouse is not your beneficiary, please provide the
beneficiary details below.

10

Beneficiary Details

Full Name

Relationship to Applicant

Full Address of the Beneficiary

Beneficiary’s Phone Number

Beneficiary’s Email Address

11

Next of Kin

Next of kin will be contacted in the absence of a designated
beneficiary or if the beneficiary cannot be reached.

Full Name of Next of Kin
*

Next of Kin Phone Number
*

Address of Next of Kin

Email Address

12

Agreement

As a member, I fully agree and abide by the rules and regulations
of EEMAA.

I hereby apply for membership and pledge to fully adhere to the
Administrative Regulations and Bylaws of EEMAA.

I also certify that the information provided above is true and correct.

Yes, I understand and agree to the terms listed above.

13

Signatures

Applicant’s Signature
*

Date Signed
*

Spouse’s Signature, If Married

Spouse Date Signed

For EEMAA Office Use Only:
Authorized EEMAA officials should complete the official review and
authorization through the Administrator Dashboard.

Application Payment Summary

One-time Membership Fee

Select fee category

Dependents Under 22
(0)

$0.00

Dependent Parents
(0)