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Section 1 - Applicant Information
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Section 2 - Type of Plan
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Select a Plan Type

Please select either an Individual of Family Plan membership. An individual is only you, a family is you, a spouse, children up to the age of 18 (24 if a full/part time student) and dependent seniors.

Section 3 - Plan Version & Schedule
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Please select a plan version (Complete or Basic) and the payment schedule of your choice.

Individual Plan Version & Schedule Options
Family Plan Version & Schedule Options
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Section 4 - Payment Options

You may choose to be billed directly based on the installment you chose or you may have the fee automatically charged each installment to a credit/debit card.

(direct billing not available for monthly installment)

Please select one
Is the name and address on the card the same as your address above?
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Section 5 - Agree to Terms and Submit Application

Please read and accept each of the terms below by clicking the check box to the left of each then e-sign the application and click on "Submit".

I agree that once received, I will read my membership agreement.

I understand that an American Legal Services, Inc. membership is an annual agreement even if you choose an installment option.

I understand that if I am paying by Credit/Debit card that my card will automatically be charged each installment. and if I choose to be billed directly each installment, I that I will receive a bill in the mail each installment period. I further understand that either billing method will remain in place until I properly cancel my account as described in my membership agreement.

All of the information that I have provided on this application is correct to the best of my knowledge.

This application is for the 2025
National Education Association
of Rhode Island (NEARI)
Open Enrollment
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You can choose to enroll here by completing this application 
or by calling

401.944.7400 

Either way the process only takes
a couple of minutes.

January 2nd - January 31st

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Add your family information here. If you have more dependents that there are spaces, simply select

 

"Additional Dependents Apply"

 

Dependents should be listed

by age.

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A monthly billing schedule requires automatic credit/debit card payments. Direct billing is not available for the monthly billing schedule. Also, there is a 90-day waiting period before benefits are active. Benefits are active as soon as your initial payment is received with any other billing schedule.

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Direct Billing means you will receive a bill in the mail each installment period.

 

Credit/Debit means that your card will automatically be charged each installment period.

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You can simulate your signature either with your finger or if you are using a PC,

you can use your mouse.

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