Civil Service Employees Association, Inc.

Information Order Form

Please fill out the following form to request more member benefit information:


Name:

Address:

City: ,

Home Phone Number:

e-mail Address:

To help us better help you, please include the following information:

Member: State Employee
Non-Member: Local Government Employee
Retiree Private Sector Employee
Date of Retirement:

Membership Kit (Member App., Jardine Insurance & In Touch With You)

Retiree Packet (Member App., Services Brochure, Retirement Guide & Retiree Order form)

Please check all that apply:

AFSCME Programs: CSEA Member Benefits:
Union Mbr. Dental Plan Retiree Dental Fee Program
Driver & Traveler Retiree Vision Program
Legal Services Cellular Phone
List of NY Lawyers Buyer's Edge
Loan Program Jardine Insurance Programs
Advantage MasterCard Jardine Security Life Plan
Secured MasterCard Jardine Retirement Counseling
Union Family $avers A Survivors' Guide
Mortgage Scholarship Program
Planning for your Retirement Member Benefits & Service Guide
CSEA/AFSCME Flyer Quest - 50% Hotel Savings Program

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