PERA Member Information Form


Membership in the Public Employees’ Retirement Association (PERA) is mandatory for permanent and temporary Classified Staff employees.

Upon initial employment, each Classified Staff employee’s information is sent to PERA. However, there may be times when the PERA may request that this form be submitted. If this is the case, you will need to complete this form and submit it to Employee Services for completion.

If you fail to complete a PERA Member Information Form as requested by PERA, this may delay future requests for refund of contributions and/or issuance of retirement benefits.

Download the form

Last updated: 11/2023