Follow the steps to complete your enrollment form effectively.

1. Press the ‘Get Form’ button to access the form and open it for editing.
2. Begin by entering your personal information. Provide your full name including first, middle, and last names, without using initials. Fill in your address, including street or P.O. Box, city, state, and ZIP code. Include your daytime telephone number and email address, and record your date of birth along with your sex status (male or female) and marital status (single, married, widowed, or divorced).
3. Next, provide your employer information. Fill in your employing agency and section or division details. Include your job classification or title, and repeat the steps of providing your daytime telephone number and email address.
4. Answer the yes or no questions regarding your employment history with public education in Alabama and your membership status with the Employees’ Retirement System. If you answered yes to any of the scenarios presented, provide details about your previous employment, including the employing agency, city, year, name under which you were employed, and date of termination.
5. Sign the form where indicated to confirm the information you provided is accurate. Also, include the date of your signature.
6. For employer certification, the employing agency must complete the annual salary, employment date, the number of pay periods per year, and employment status. Ensure that the employer signs and dates this section.
7. Designate your primary beneficiaries by providing their names, relationships to you, dates of birth, and addresses. Repeat this for each primary beneficiary.
8. In case your primary beneficiary does not survive you, designate contingent beneficiaries by providing the same details as required for primary beneficiaries.
9. Sign the beneficiary designation certification and state the date. This signature should be acknowledged before a notary public, who will complete the notary section.
10. Once you have filled out all sections of the form, review the information carefully. Save the changes, then download or print the completed form for your records or submission.

Complete your AL ERS Enrollment Member Information Record online today for seamless processing!