Get Blue Cross Local Form - Salsa!

The Blue Cross Local Form - Salsa! is an essential document for classified employees to notify their respective parties about local dues. This guide will provide you with clear instructions on how to complete the form online, ensuring that you accurately fill out each section.

Follow the steps to effectively complete the Blue Cross Local Form - Salsa!

1. Click ‘Get Form’ button to obtain the form and open it in your preferred online editor.
2. Begin by entering the name of the school district or employer in the specified section. This is crucial for ensuring that the proper party receives your notification.
3. Next, indicate the total annual amount of local dues per member for the specified membership year by selecting the appropriate salary break range. This information is found in the table provided on the form.
4. In the following section, indicate the number of pay periods over which annual dues will be collected. Choose from the options provided or specify another number if applicable.
5. You will then be prompted to select whether local dues will be collected through the WEA Premera APA System. Make sure to check ‘Yes’ or ‘No’ accordingly.
6. Fill in the affiliate or district name in the designated area, ensuring that it is clearly spelled out for accurate record-keeping.
7. Lastly, provide your contact information including your name, title, email, and phone number, followed by the date of completion.
8. Once all fields are complete, review your entries for accuracy before saving the changes. You can download, print, or share the form as needed.

Complete your Blue Cross Local Form - Salsa! online today to ensure timely submission and proper processing.