Membership Form

ORTA MEMBERSHIP FORM
ORTA
8050 North High Street Ste. 190
Columbus OH 43235-6488

Please complete the form below and submit it to complete your new membership.

Name (as shown on STRS benefit check)

Mailing Address City State
Zip Code County
Date of Retirement
Your E-mail Address
Membership Being Purchased (Enter Yearly or Lifetime)

SUBMIT FORM below:

Thank you for your payment for ORTA dues. Your transaction has been completed and a receipt has been e-mailed to you.