ACOE Online Registration and Renewal System

"*" indicates required fields

Member Number

WellCard

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Date

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GTS

Recruiter

If you are not the recruiter named in this box, please close this form, login to your personal page and choose the Enter Paper Application choice.

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Country

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Status (View, edit, update)

Member

Renewal

Hold

V-Delete

Click View, Edit, Then Save

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MemberInfoUpdate

Paper Application Entry Form

WhatDo*

If you have been an ACOE member in the past 12 months, choose the "Renew My Membership" option.

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Do you want your membership to start on August 1, 2021?*

YES

You can join ACOE now, but not have your membership begin until August 1, 2021. If you choose this option, your dues, benefits, and coverages will not begin until August 1, 2021.

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MemberCat

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If you received a SPECIAL CODE, enter it here.

When you join ACOE as a new teacher, you will setup a dues payment method and ACOE will mail you a check for $105 in December.

IMPORTANT: You cannot list someone as referring you to ACOE and receive the $105 discount.

IMPORTANT: ACOE members CANNOT be employed by a third party such as a Sub-Service and

MUST receive a W-2 from their school district.

Counselor Members: If you hold an Alabama Teacher's Certificate,

choose Certified Teacher, otherwise choose Support Professional.

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AEA or AFT Notice

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GTS

If you are a member of AEA or AFT, you can JOIN ACOE now and set your ACOE Membership beginning date (Near the end of the registration process.) for 9/1/2023. At the end of the ACOE Membership registration process, you will be emailed a web link that will take you to ACOE's "Cancelling Another Organization" portal. You can use the portal to help you cancel your AEA or AFT membership effective June 2023.

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Did you notify AEA or AFT before the September 15th deadline to cancel your membership?

YES

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Have you received confirmation from AEA or AFT that your membership has been cancelled?

YES

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At the end of the registration process, ACOE will email you the information you need for cancelling your AEA or AFT membership. You must cancel your AEA or AFT membership before the September 15th deadline.

Would you like to continue your ACOE registration?

YES

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Do you want ACOE to email you information to help you cancel your AEA or AFT membership?

YES

ACOE will send you an email containing links that direct you to specific information needed for cancelling your AEA or AFT membership before the September 15th deadline.

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Non Certified Teacher

Is the school where you work accedited?*

YES

Answering no to this question does not limit your ability to join ACOE.

However, we may contact you can make sure your position is covered by our insurance.

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Certified Teacher, Support, Admin or Superintendent or student teacher upgrade

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My WORK LOCATION was found.

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I was given a bank draft application.

I was given a Bank Draft Application

If you are recruiting in a district that offers Payroll Deduction and you received a Bank Draft application, check the box above.

Since you were given a bank draft application in a payroll deduction district, choose payroll deduction and then enter the bank information in the bank draft box below. We will sort it out in the office.

PD Dues Option

Enter your Credit Card information when you get to the bottom of this form.

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Hide If Student teacher Upgrade

One Year ACOE Membership Dues

Price:

One Year ACOE Membership Dues with Processing Fee

Price:

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BD Dues Option

Enter your Credit Card information when you get to the bottom of this form.

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Sub Teacher

Sustitute Teacher Option:*

Enter your Credit Card information when you get to the bottom of this form.

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I am having trouble viewing the bank draft authorization form below.

Bank Draft Authorization Form Example:

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Bank Draft Box (BELOW)

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One Year ACOE Membership Dues

Price:

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ACOE / Member Agreement

By checking the box below, I acknowledge that I understand: 1) My membership will not be effective until steps to begin monthly BANK DRAFT installments have been completed. 2) ACOE membership is a 12-month membership, not a month to month membership. 3) BANK DRAFT allows annual dues of $210 to be spread over 12 equal payments of $17.50 per month per membership year. 4) The balance of my dues will be collected if I cancel my membership prior to the end of my 12-month membership cycle. 5) This option automatically renews each membership year with no action required on my part. 6) Declined bank drafts will result in a service charge. 7) I will receive a full year of benefits, liability insurance and legal services beginning and ending on my membership anniversary date. 8) ACOE liability insurance and legal services DO NOT cover any administrative duties or actions.

I understand and accept the ACOE / Member Agreement

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Student Teacher Upgrade Begin

Student Teacher Upgrade Dues

Price:

Student Teacher Upgrade Dues

Price:

IMPORTANT:

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Student Teacher Upgrade End

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When Payroll Deduction is Chosen

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Today
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Payroll Deduction Notice:

May not be available in your district on or after September 15th. You can still join ACOE via Bank Draft at $15.75 per month. 

Your yearly dues will still only be $189 per year. 

During the next open enrollment period we can easily switch you over to payroll deduction if you prefer it.

BALDWIN COUNTY: When joining ACOE and paying your membership dues through payroll deduction, you will not be required to send a payroll deduction form to your school district payroll department. ACOE will handle all communications with your school district payroll department and setup monthly payroll deductions for you. Be sure to fill-in the signature and SSN information below so ACOE will have this information to start your payroll deductions.

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Student Teacher Section

Student Dues Option

Enter your Credit Card information when you get to the bottom of this form.

Student Teacher Dues: $25.00 per year.

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Retired Teacher or Support Pro

Retired Dues Option

Enter your Credit Card information when you get to the bottom of this form.

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Total Dues

Total Yearly Dues:

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Special Discount
Only past ACOE members who are rejoining ACOE after not being a member for at least two years are eligible to receive a special discount code. The discount expires after September 15th. NOTE: You cannot list anyone as referring you to ACOE if the discount code is used. Retired ACOE memberships, Student Teacher memberships, and Student Teacher Upgrades are not eligible for the ACOE reimbursement program.

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When Bank Draft is Chosen

Add Your Bank Draft Information Below

Use the Bank Draft form below to enter your bank information.

The information you enter is secured with bank level encryption.

After you enter your bank information, please complete the remainder of

the registration process.

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Update Information

Since you are renewing or updating your ACOE membership you only need to update information that has changed.

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**Personal Information Section ( * indicates Required Field)**

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Username

*First Name*

*Middle Initial

*Last Name*

Maiden Name

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*Address*

*City*

State: Choose from the drop down list.*

*Zip Code*

*Main Phone: One you are likely to answer.*

Secondary Phone

*Personal Email Address: ACOE's main contact method.*

Work / School Email Address

IMPORTANT: If you work in the Jefferson County School System or the

Blount County School System, please do not enter your work email as a contact.

These systems have strict rules concerning school email usage.

If you entered a work email address as your personal email, we ask that you enter a non-work email.

ACOE will never abuse your email account.

IMPORTANT: ACOE is not allowed to send emails to your district's email address.

Please make sure that you provided ACOE with a Personal Email address that is current.

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Choose your school system and school:*

Work Location NOT FOUND

School District Not Found: In which town is your school located?

School District:*

Work Location:*

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Choose the College or University where you work or attend.

Click the box if your school was not found.

If your college or university is not listed, please enter it here.

What is your expected graduation date?*
MM slash DD slash YYYY

IMPORTANT: The month and year are important. A specific day is not important.

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**Personal Information Section ( * indicates Required Field)**

Job Category: Choose from the drop down list.*
Please choose the category that best describes

the job or function you do most of the time while at work.

Were you referred to ACOE by anyone?

NO

YES

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**ACOE Referral Information Section ( * indicates Required Field)**

Tell us about the person who referred you to ACOE.

*Name of referring person.*
First Last

School System / School of Referring Person

Please select the school where the person referring you works.

If you are not sure, choose a school in the district where the referring person works.

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Schools List (Referring Person)
Please select the school where the person referring you works.

If you are not sure, choose a school in the district where the referring person works.

Click the box if your school was not found.

School Not Found: Provide information here.

Please provide as much information as you can so we can identify the person who recruited you.

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**Personal Information Section ( * indicates Required Field)**

When do you want your membership to begin?
MM slash DD slash YYYY

Pay dues with a check?

I have a check with this application.

No check pay with this application.
Paying with a check should only be chosen if you have the check in your possession. If not, close this form and give the application to your ACOE supervisor. If a check was provided to start Bank Draft, choose NO CHECK PAY.

Payment Type

Check

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Full SSN

Attention Paid Recruiter:

If you cannot find a Social Security Number on the paper application,

just enter all zeros to alert our office personnel.

IMPORTANT: Your school system requires your full Social Security Number for payroll deduction.

Please enter your full SSN (Without Dashes) below or choose another form of dues payment.

(For your safety, ACOE uses a secure connection.)

Social Security Number*

Attention Paid Recruiter:

If you cannot find a Social Security Number on the paper application,

just enter all zeros to alert our office personnel.

Your district requires a full SSN.

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Last 4 SSN

Last 4 of Your Social Security Number*

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Full SSN

Social Security Number

Paper applications require full SSN for payroll Deductions If the member only provided the last 4 digits, fill in all other digits with zeros. Example: 000-00-9999

To complete the dues payment process, submit your information to ACOE and follow the

directions presented at the end of your registration.

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**Personal Information Section ( * indicates Required Field)**

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Paid Recruiter Information

Enter the primary and / or secondary recruiter if they are listed at the bottom of the paper application. If none are listed, leave blank.

Notes
Enter any concerns about this paper application in this box. You are limited to 200 characters and spaces.

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agreements

ACOE / Student Teacher Agreement
The insurance benefits provided to me as an ACOE Student Teacher Member only cover me for duties performed as a student teacher under the supervision of an accredited institution of higher learning.

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Agreements 2

ACOE / Member Agreement
Important Note: By checking the box below, I acknowledge that I understand: 1. My membership will not be effective until my dues have been received by ACOE or steps to begin monthly installment payments have been completed. 2. That I agree to pay my total yearly dues of $210 in full even if paying in monthly installments. 3. I will receive a full year of benefits, liability insurance and legal services beginning and ending on my membership anniversary date. 4. ACOE liability insurance and legal services DO NOT cover any administrative duties or actions.

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I understand and accept the ACOE / Member Agreement

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Please sign in the middle of the signature box below. You can use your mouse or touch screen to write in the box.

Please review the following information before you submit it to ACOE.
If you need to change any information, scroll up the page and make changes.
After you have updated your information, press the submit button at the bottom of the webpage.

Information Summary

General Information:

Application Type: {:466} Current Status: {:467}

AEA/AFT Member:{:469}

Personal Demographics: Phone and Email Information:

{:67} {:68} {:70} Main Phone:{:21}

{Maiden Name:69:label} {:69} Secondary Phone: {:22}

{Address:71}

{City:74}, {State:75} {Zip Code:72} Personal Email:{:2}

SSN:{:342}{:348}{:362} School Email: {:20}

Employment / School Information:

District (If applicable): {:37}{:178}{:335.1} {:465}

School / Work Location: {:179}{:144}{:335.2}{:127}{:128} {:251}{:252}

{What is your expected graduation date?:107:label} {:107}

Job Category:{Job Category:56:value}

{Is the school where you work accedited?:138:label} {:138}

Referral Information:

Referred by anyone: {:38}

Referred by: {:40.3} {:40.6}

Location: {:39}{:147}{:339.1}  {:465}

{:339.2}

Other Information:

How did you hear about  ACOE? {:476}

Would you like more information about  ACOE? {:106}

Dues Payment Information:

Payment Method: {:470}{:487}{:488}{:501}{:500}{:502}

Yearly Dues:  {:510}

When do you want your membership to begin? {:41}

{:512}

{:514}

Personal Demographics:	Phone and Email Information:
{:67} {:68} {:70}	Main Phone:{:21}
{Maiden Name:69:label} {:69}	Secondary Phone: {:22}
{Address:71}
{City:74}, {State:75} {Zip Code:72}	Personal Email:{:2}
SSN:{:342}{:348}{:362}	School Email: {:20}

Employment / School Information:
District (If applicable): {:37}{:178}{:335.1} {:465}
School / Work Location: {:179}{:144}{:335.2}{:127}{:128} {:251}{:252}
{What is your expected graduation date?:107:label} {:107}
Job Category:{Job Category:56:value}
{Is the school where you work accedited?:138:label} {:138}

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Credit Card Entry

Since you chose to have your ACOE membership begin August 1, 2022, ACOE will email you after August 1, 2022, and ask you to pay your dues at that time.

Please finish the remainder of the registration process.

Credit Card
Card Details
Enter the name on your card.

RECRUITER NOTE:

If the payment method marked on the paper application was Bank Draft, after you press the SUBMIT button and see the Bank Draft confirmation page, you are finshed with this application.

An ACOE employee will set up the Bank Draft for this member. Send the paper application to ACOE asap

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Paper Application Entry Form

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AEA or AFT Notice

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Non Certified Teacher

Certified Teacher, Support, Admin or Superintendent or student teacher upgrade

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Sub Teacher

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ACOE / Member Agreement

Student Teacher Upgrade Begin

Student Teacher Upgrade End

When Payroll Deduction is Chosen

Student Teacher Section

Retired Teacher or Support Pro

Total Dues

When Bank Draft is Chosen

Add Your Bank Draft Information Below

Update Information

Since you are renewing or updating your ACOE membership you only need to update information that has changed.

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Personal Information Section ( * indicates Required Field)

Hide Addess Info

IMPORTANT: If you work in the Jefferson County School System or the

Blount County School System, please do not enter your work email as a contact.

These systems have strict rules concerning school email usage.

If you entered a work email address as your personal email, we ask that you enter a non-work email.

ACOE will never abuse your email account.

IMPORTANT: ACOE is not allowed to send emails to your district's email address.

Please make sure that you provided ACOE with a Personal Email address that is current.

Hide If Student Teacher

End of School Section

Begin College Section

End College Section

Personal Information Section ( * indicates Required Field)

ACOE Referral Information Section ( * indicates Required Field)

Personal Information Section ( * indicates Required Field)

Full SSN

Last 4 SSN

Full SSN

To complete the dues payment process, submit your information to ACOE and follow the

directions presented at the end of your registration.

Personal Information Section ( * indicates Required Field)

Paid Recruiter Information

agreements

Agreements 2

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Credit Card Entry

**Personal Information Section ( * indicates Required Field)**

**Personal Information Section ( * indicates Required Field)**

**ACOE Referral Information Section ( * indicates Required Field)**

**Personal Information Section ( * indicates Required Field)**

**Personal Information Section ( * indicates Required Field)**