Apply for the RAM Program Step 1 of 5 20% IMPORTANT: This application is for NEW RAM members ONLY.Member InformationName(Required) First Last Agency/Association(Required)(No abbreviations please)Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email(Required) Cell Phone(Required)Date of Birth(Required) MM slash DD slash YYYY Retirement Date(Required) MM slash DD slash YYYY Were you a sworn peace officer or non-sworn personnel?(Required) Sworn Peace Officer under PC 830 Non-Sworn Non-Sworn Do you have an existing PORAC member number?(Required) Yes No Unsure Member Number(Required)Identification Card(Required)If you do not have a PORAC member number, you MUST submit a copy of your retired identification card (front & back). Please upload below, fax to (916) 999-8890, email ramsam@porac.org or mail a copy to PORAC RAM, 2940 Advantage Way, Sacramento, CA 95834. NOTE: Your RAM application CANNOT be processed until we have received a copy of your retirement ID.Accepted file types: jpg, jpeg, gif, pdf, tif, png, Max. file size: 3 MB. Membership Type and Renewal InformationMembership Type(Required) LAAPOA RAM Membership - $62.50/mo. ($750/yr.) Your membership renews on an annual basis. How would you like to receive your annual invoice?(Required) Electronically to e-mail provided Hardcopy via USPS to address provided (you will receive BOTH a hardcopy and an electronic invoice) SignatureRefund Policy All Refunds requests must be received, in writing, by LAAPOA within 45 days after your application has been approved in order to receive a full refund. After 45 days, no refunds will be processed. You may contact LAAPOA via email at benefits@laapoa.com or by phone at (424) 374-8159Member's Signature(Required)Your signature below indicates you acknowledge and accept the RAM/RLDF Refund Policy noted above.Signature Date(Required) MM slash DD slash YYYY Employees Club of CaliforniaPlease complete the following Payroll Deduction Authorization Form and return it to the Employees Club of California. Your payroll deduction will become effective as soon as the City Controller processes your request. Please note it can take up to two pay periods for the City Controller’s office to process your deduction. The Club will do everything possible to ensure your payroll deduction gets processed sooner.Member InformationName(Required) First Middle Last Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email*(Required) Cell Phone(Required)The email address you provide will help the Club communicate with you regarding important updates and benefits that may become available to you. Your email address is used solely by the Employees Club of California and will not be distributed to others. Deduction Status UpdatePlease select the reason for your change/update to your deduction.(Required) I’ve changed departments within the City I’ve retired/ or will be retiring I am a Surviving Spouse Other Date of Birth(Required) MM slash DD slash YYYY Retirement Date(Required) MM slash DD slash YYYY City Department Number(Required)City Employee Number(Required)Payroll/Pension Deduction Authorization I hereby authorize the deduction from my salary or pension of amounts sufficient to cover premiums/membership fees on any of my group benefits provided by the Employees Club of California. In the event any premiums should change due to age, increase in salary or benefits, or a general rate increase for the entire Association, I authorize you to make such change upon notification from the Employees Club of California and such deduction to remain in force until canceled by me in writing.Member's Signature(Required)Signature Date(Required) MM slash DD slash YYYY PaymentPlease take a moment to review your order. Your monthly dues cover the following Associate Member Benefits: PORAC RAM Membership PORAC LDF Firearm Coverage (HR-218) LACEA Club Membership LAAPOA LTC LAAPOA EyeMed Dues in the amount of $62.50 will be deducted from your payroll each month. Press the Submit button below to confirm your membership.CAPTCHANameThis field is for validation purposes and should be left unchanged. Δ
