NBEA Membership Form

Payroll Deduction is available to Xerox Technology Employees and Xerox Services Employees. Xerox Technology, Xerox Services and “Friends of NBEA” memberships are also available via Paypal.


Work Year: *  This Year (2016)

Name: *

Employee ID: *

E-mail: *

Division or Organization:

Job Field:




Payment Method: *  Payroll Deduction (Xerox Technology and Xerox Services Employees) PayPal (Xerox Technology, Xerox Services, and Friends of NBEA )

Member Level - Payroll Deduction: *  $30: Xerox Technology Employee $30: Xerox Services Employee (Employee of a Wholly Owned Subsidiary/Affiliate)

Membership Level - Pay Pal:  Xerox Employee $ 30.00 USD Employee of a Wholly Owned Xerox Subsidiary or Affiliate $ 30.00 USD Friends of NBEA $ 30.00 USD

Friend Type: *  Xerox Retirees Contractors Family Members Friend

Education Level:

Year of Service: *

Employee Status: *  Exempt Non-Exempt Intern/Co-op

Age Range:

NBEA Chapter: *  NBEA Upstate New York NBEA Carolina NBEA DMV NBEA Greater Los Angeles Area NBEA Georgia NBEA Texas NBEA New England NBEA Chicago Metro Virtual

How would you like to serve in NBEA ?

How did you hear about the NBEA ?