Membership Application Form

Instructions

This form is designed for new members. If you have ever been a RIPEA member, it's best to log into the Member Info Hub or contact the RIPEA office at 317-789-0244 to pay by card.

Select An Option

Regular - One Time $18 Annually

For retirees requiring annual membership invoicing (instead of providing RIPEA with a recurring payment method to autopay each year)

Regular - Recurring $15 Annually

For retirees providing RIPEA with a recurring payment method to autopay each year ($3 savings!)

Associate - One Time $10 Annually

For spouses of retiree members requiring annual membership invoicing (instead of providing RIPEA with a recurring payment method to autopay each year)

Associate - Recurring $10 Annually

For spouses of retiree members providing RIPEA with a recurring payment method to autopay each year

Enter Contact Information

Prefix (i.e. Mr. Mrs. Dr.)

First Name

Last Name

Suffix (i.e Jr. Sr. III)

Designations

E-mail

Family NameBusiness Name

Please select a valid membership option and fee item if exist