Application for Membership - Public Employees Retirement 2026

1. Click ‘Get Form’ to open the Application for Membership in the editor.
2. Begin by filling out the MEMBER INFORMATION section. Enter your SOCIAL SECURITY NUMBER or PERA ID NUMBER, FIRST NAME, MIDDLE INITIAL, LAST NAME, and MAILING ADDRESS clearly.
3. Provide your HOME or CELL TELEPHONE NUMBER and BUSINESS TELEPHONE NUMBER. Ensure that you also include your CITY, STATE, ZIP CODE, DATE OF BIRTH, and CITY OF BIRTH.
4. Indicate your CURRENT MARITAL STATUS by checking the appropriate box. Answer whether you have ever been a PERA member and if you are currently receiving a pension from ERA.
5. In the FAMILY INFORMATION section, list your SPOUSE’S NAME, SSN, DATE OF BIRTH, and CHILDREN’S NAMES along with their SSNs and DATES OF BIRTH as needed.
6. Complete the MEMBER CERTIFICATION by signing and dating the form to confirm that all information is accurate.
7. Finally, ensure that any corrections are sent to PERA if your information changes after submission.

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