new member application state join oday! new member ... · oday! ® 03/2018 jjla: state city...
TRANSCRIPT
NEW MEMBER APPLICATIONCity Employees Club
As a Club Member You’ll Enjoy These
VALUABLE BENEFITS:
Join Today!
03/2
018
JJLA
: S
TAT
E
®
City Employees Club 120 West 2nd Street • Los Angeles, CA 90012(800) 464-0452 • www.cityemployeesclub.com
The City Employees Club is a membership program of LACEA Insurance Services, Inc. (CA DOI Lic. #0B98000). LACEA Insurance Services, Inc. is a licensed insurance agency offering insurance benefits to qualified Club members.
DiscountTickets!
DiscountTickets!
STATECity Employees Club
New Member Application
Join Today!
Cheap tickets. Insane Service. Affordable Insurance.
®
Up to 60% Off!N
O P
OST
AG
E
NEC
ESSA
RY
IF M
AIL
ED
IN T
HE
UN
ITED
STA
TES
SEA
L W
ITH
TA
PE B
EFO
RE M
AIL
ING
- D
O N
OT
STA
PLE
CIT
Y E
MP
LOY
EE
S C
LUB
OF
LOS
AN
GE
LES
31
1 S
SP
RIN
G S
T S
TE 1
300
LOS
AN
GE
LES
CA
900
13-9
844
NO
PO
STA
GE
NE
CE
SS
AR
YIF
MA
ILE
DIN
TH
EU
NIT
ED
STA
TES
BU
SIN
ES
S R
EP
LY M
AIL
FIR
ST-
CLA
SS
MA
ILLO
S A
NG
ELE
S C
AP
ER
MIT
NO
. 627
22
PO
STA
GE
WIL
L B
E P
AID
BY
AD
DR
ES
SE
E
Artw
ork
for
Env
elop
e, 3
.75
x 8.
5 (3
.75"
x 8
.5")
Layo
ut: s
ampl
e B
RM
Env
with
IMB
.lyt
Oct
ober
3, 2
012
Pro
duce
d by
DA
Zzle
Des
igne
r 200
2, V
ersi
on 9
.0.0
5(c
) 199
3-20
09, E
ndic
ia, w
ww
.End
icia
.com
U.S
. Pos
tal S
ervi
ce, S
eria
l #N
O
IMP
OR
TAN
T: D
O N
OT
EN
LAR
GE
, RE
DU
CE
OR
MO
VE
the
FIM
and
PO
STN
ET
barc
odes
. The
y ar
e on
ly v
alid
as
prin
ted!
Spe
cial
car
e m
ust b
e ta
ken
to e
nsur
e FI
M a
nd P
OS
TNE
T ba
rcod
e ar
e ac
tual
siz
e A
ND
pla
ced
prop
erly
on
the
mai
l pie
ce t
o m
eet b
oth
US
PS
regu
latio
ns a
nd a
utom
atio
n co
mpa
tibili
ty s
tand
ards
.
CIT
Y E
MP
LOY
EE
S C
LUB
OF
LOS
AN
GE
LES
31
1 S
SP
RIN
G S
T S
TE 1
300
LOS
AN
GE
LES
CA
900
13-9
844
NO
PO
STA
GE
NE
CE
SS
AR
YIF
MA
ILE
DIN
TH
EU
NIT
ED
STA
TES
BU
SIN
ES
S R
EP
LY M
AIL
FIR
ST-
CLA
SS
MA
ILLO
S A
NG
ELE
S C
AP
ER
MIT
NO
. 627
22
PO
STA
GE
WIL
L B
E P
AID
BY
AD
DR
ES
SE
E
Artw
ork
for
Env
elop
e, 3
.75
x 8.
5 (3
.75"
x 8
.5")
Layo
ut: s
ampl
e B
RM
Env
with
IMB
.lyt
Oct
ober
3, 2
012
Pro
duce
d by
DA
Zzle
Des
igne
r 200
2, V
ersi
on 9
.0.0
5(c
) 199
3-20
09, E
ndic
ia, w
ww
.End
icia
.com
U.S
. Pos
tal S
ervi
ce, S
eria
l #N
O
IMP
OR
TAN
T: D
O N
OT
EN
LAR
GE
, RE
DU
CE
OR
MO
VE
the
FIM
and
PO
STN
ET
barc
odes
. The
y ar
e on
ly v
alid
as
prin
ted!
Spe
cial
car
e m
ust b
e ta
ken
to e
nsur
e FI
M a
nd P
OS
TNE
T ba
rcod
e ar
e ac
tual
siz
e A
ND
pla
ced
prop
erly
on
the
mai
l pie
ce t
o m
eet b
oth
US
PS
regu
latio
ns a
nd a
utom
atio
n co
mpa
tibili
ty s
tand
ards
.
CIT
Y E
MP
LOY
EE
S C
LUB
OF
LOS
AN
GE
LES
31
1 S
SP
RIN
G S
T S
TE 1
300
LOS
AN
GE
LES
CA
900
13-9
844
NO
PO
STA
GE
NE
CE
SS
AR
YIF
MA
ILE
DIN
TH
EU
NIT
ED
STA
TES
BU
SIN
ES
S R
EP
LY M
AIL
FIR
ST-
CLA
SS
MA
ILLO
S A
NG
ELE
S C
AP
ER
MIT
NO
. 627
22
PO
STA
GE
WIL
L B
E P
AID
BY
AD
DR
ES
SE
E
Artw
ork
for
Env
elop
e, 3
.75
x 8.
5 (3
.75"
x 8
.5")
Layo
ut: s
ampl
e B
RM
Env
with
IMB
.lyt
Oct
ober
3, 2
012
Pro
duce
d by
DA
Zzle
Des
igne
r 200
2, V
ersi
on 9
.0.0
5(c
) 199
3-20
09, E
ndic
ia, w
ww
.End
icia
.com
U.S
. Pos
tal S
ervi
ce, S
eria
l #N
O
IMP
OR
TAN
T: D
O N
OT
EN
LAR
GE
, RE
DU
CE
OR
MO
VE
the
FIM
and
PO
STN
ET
barc
odes
. The
y ar
e on
ly v
alid
as
prin
ted!
Spe
cial
car
e m
ust b
e ta
ken
to e
nsur
e FI
M a
nd P
OS
TNE
T ba
rcod
e ar
e ac
tual
siz
e A
ND
pla
ced
prop
erly
on
the
mai
l pie
ce t
o m
eet b
oth
US
PS
regu
latio
ns a
nd a
utom
atio
n co
mpa
tibili
ty s
tand
ards
.
CIT
Y E
MP
LOY
EE
S C
LUB
311
S S
PR
ING
ST
ST
E 1
300
LOS
AN
GE
LES
CA
900
13-9
844
PO
STA
GE
WIL
L B
E P
AID
BY
AD
DR
ES
SE
E
FIR
ST-
CLA
SS
MA
IL
P
ER
MIT
NO
. 627
22
LO
S A
NG
ELE
S C
AB
US
INE
SS
RE
PLY
MA
IL® ®
Your Club Membership CardYour personalized club membership card will arrive in the mail approximately one week after we receive your membership application.
You’ll want to take it with you everywhere you go — it’s your passport to a world of discounts, benefits, events, connections and fun!
BIG Discounts! & Savings on:• Movie Tickets• Amusement Parks• Attractions• Car Rentals• Hotels• eTickets available
• Omaha Steaks• Hotel Storm• Skechers • Office Depot• Restaurant.com• Avis
• Club VIP Signature Events• Scholarship Program• Free Notary Service
Partner Discounts:
More Benefits:
Up to 60% Off!
Discount Tickets!
Club
Cou
nsel
or
Dat
e /
/
Join Today!
Membership Application
Membership in the Employees Club of California (The Club) is now being
offered to employees of the State of California.
When you become a member of the Club, you will have exclusive access to amazing membership benefits (like discount tickets and special events). Go to our website,
www.cityemployeesclub.com for all the details.
* Th
e e-
mai
l add
ress
you
pro
vide
will
help
us
com
mun
icat
e w
ith y
ou re
gard
ing
upda
tes
and
bene
fits
that
may
bec
ome
avai
labl
e to
yo
u. Y
our e
-mai
l add
ress
will
be u
sed
sole
ly b
y th
e Ci
ty E
mpl
oyee
s Cl
ub a
nd w
ill no
t be
dist
ribut
ed to
oth
ers.
Nam
e of
Ass
ocia
tion
Firs
t N
ame
M
iddl
e In
itial
La
st N
ame
Hom
e A
ddre
ss
City
Sta
te
Zip
Hom
e P
hone
W
ork
Pho
ne
Cel
l Pho
ne
D
ate
of B
irth
(MM
/DD
/YY
YY
)
Dep
artm
ent
Nam
e
Jo
b Ti
tle
Faci
lity
Nam
e
m
Mal
e
m F
emal
e
Wor
k A
ddre
ss
City
Sta
te
Zip
E-m
ail a
ddre
ss*
(no
stat
e e-
mai
l)
Ref
erre
d by
Mem
ber
No.
Soc
ial
Sec
urity
N
umbe
r
/
/
(
)
(
)
(
)
Cit
y E
mp
loye
es C
lub
New
Mem
ber
In
form
atio
n:
03/2018 JJLA: STATE
INST
RUCT
ION
S: S
impl
y co
mpl
ete
this
form
, and
then
com
plet
e an
d sig
n th
e Pa
yrol
l Ded
uctio
n Au
thor
izatio
n (b
elow
). Fo
ld th
is en
tire
broc
hure
with
the
Busin
ess
Repl
y Pa
nel s
how
ing,
tape
clo
sed
(don
’t us
e a
stap
le) a
nd
drop
in th
e m
ail.
We
will
proc
ess
your
app
licat
ion
and
send
you
r mem
bers
hip
card
in a
bout
two
wee
ks.
®
Cit
y E
mp
loye
es C
lub
120
Wes
t 2nd
Stre
et •
Los
Ange
les,
CA
9001
2(8
00) 4
64-0
452
• ww
w.c
ityem
ploy
eesc
lub.
com
For e
mpl
oyee
s of
the
Stat
e of
Cal
iforn
ia
PAYR
OLL
DED
UC
TIO
N A
UTH
OR
IZAT
ION
Last
Nam
e
Fir
st N
ame
Mid
dle
Init
ial
Org
aniz
atio
n N
ame
Los
An
gel
es C
ity
Em
plo
yees
Ass
oci
atio
n, I
nc.
(LA
CE
A)
Soc
ial
Sec
urity
N
umbe
r
D
ed./
Org
. Co
de:
Cal
iforn
ia S
tate
Em
plo
yee
Dat
e
Sign
H
ere
X /
/
03/2018 JJLA: STATE
I her
eby
auth
orize
the
Stat
e Co
ntro
ller t
o de
duct
from
my
sala
ries
and
wag
es th
e am
ount
spe
cifie
d no
w o
r in
the
futu
re fo
r mem
bers
hip
dues
and
any
ben
efit
prog
ram
for w
hich
I ha
ve a
pplie
d, w
hich
is
spon
sore
d by
the
abov
e na
med
org
aniza
tion.
This
auth
oriza
tion
will
rem
ain
in e
ffect
unt
il can
celle
d by
me
or b
y th
e ab
ove
nam
ed o
rgan
izatio
n.
I cer
tify
that
I am
a m
embe
r of t
he a
bove
nam
ed o
rgan
izatio
n, a
nd u
nder
stan
d th
at te
rmin
atio
n of
m
embe
rshi
p w
ill ca
ncel
all d
educ
tions
mad
e un
der t
his
auth
oriza
tion.
Cal
iforn
ia S
tate
Con
trol
ler
TO:
08
9-0
67
FOR
OFF
ICE
US
E O
NLY
Cod
e D
educ
tion
CALL THE CLUB TOLL FREE:(800) 464-0452
VISIT THE CLUB STORE:120 W. 2nd StreetLos Angeles, CA 90012– FREE validated parking at
Joe’s Parking behind the Club Store. Parking entrance located at 220 S. Spring St., Los Angeles, CA 90012
BUSINESS HOURS:– 8 a.m. to 4:30 p.m., Mon. - Fri.
Harle
m P
l.
W. 2nd St.
3rd St.
Mai
n St
.
Spri
ng S
t.
City Hall
Caltrans/DOT
LAMall
City HallEast
LAPD
Headquarters
1st Street
Temple St.
Los
Ange
les
St.
N
ClubStore
City HallSouth
Join the City Employees ClubThe Club is your passport to hundreds of dollars in savings on movie tickets, theme parks, entertainment, and destinations. You’ll automatically receive all Club membership benefits for a payroll deduction of only $6.00 per month.
Find out more about the Club and all its benefits at www.cityemployeesclub.com
Club Members Enjoy:
UP TO 60% OFFDiscount Tickets to movies and attractions like…
• AMC Theaters• Regal/Edwards/UA• Six Flags Magic Mountain• Knott’s Berry Farm• ...and many more.
Club Store 24/7 online access for:• Exciting sporting and special event tickets• Online ordering of discount tickets: no waiting in line!
Other Benefits: • Free Notary Service
(Contact the Club to make an appointment)