Member Card Social share icons You must have JavaScript enabled to use this form. Leave this field blank YES! I want to join with coworkers as a member of AFSCME to win respect and improve our quality of life! First Name Middle Initial Last Name Street Address Apartment, Suite, etc. City State - Select -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Employer Date of Hire Occupation Department Personal Email Cell Phone † † By providing my cell phone number I consent to receive calls (including recorded or autodialed calis, or texts) at that number from AFSCME and its affiliated labor, political and charitable organizations on any subject matter. My carrier's rates may apply. I may modify my preferences by calling the Union at (412) 922-2550 or emailing the Union at membershipAFSCMEVA@afscme.org. By providing my cell phone number I consent to receive calls (including recorded or autodialed calls, or texts) at that number from AFSCME and its affiliated labor, political and charitable organizations on any subject matter. My carrier’s rates may apply. Authorization I hereby apply for membership in the American Federation of State, County and Municipal Employees, AFL-CIO, and its successor or assign (hereafter the "Union") and I agree to abide by its Constitution and Bylaws. I authorize the Union to act as my exclusive bargaining representative for purposes of collective bargaining with respect to wages, hours and other terms and conditions of employment with my Employer. This card may be used in support of requiring a vote for adoption of an ordinance or resolution to provide collective bargaining, and to establish or obtain recognition of the Union with my Employer, with or without an election. Upon being covered by an agreement with my Employer, I hereby voluntarily authorize and direct my Employer to deduct from my pay each pay period, regardless of whether I am or remain a member of the Union, the amount of dues certified by the Union, and as they may be adjusted periodically by the Union, and to authorize my Employer to remit such amount monthly to the Union. This voluntary authorization and assignment shall be irrevocable, regardless of whether I am or remain a member of the Union, for a period of one year from the date of execution, and for year to year thereafter unless I give the Employer and the Union written notice of revocation not less than ten (10) days and not more than twenty (20) days before the end of any yearly period, or other time period provided in an applicable ordinance or resolution. This card supersedes any prior check-off authorization card I signed. I recognize that my authorization of dues deductions, and the continuation of such authorization from one year to the next, is voluntary and not a condition of my employment. Payments to the Union are not deductible as charitable donations for federal income tax purposes. However, state law may extend favored tax treatment. Signature Reset My electronic signature is a binding and valid signature. By signing here I agree to all of the terms and conditions set out in this authorization, which apply to my membership, dues payments and, if applicable, PEOPLE payments. PEOPLE: Fighting for Candidates Who Will Fight for UsAs people in public service, we know what a difference it makes when we elect leaders who have our backs. We deserve leaders who respect our work and that's why we fight.AFSCME uses voluntary contributions collected through its PEOPLE program, not dues, to contribute to candidates for federal office and in certain states where other funding is restricted. In other states, AFSCME may use dues money to support candidates who support improving public services. AFSCME makes this information public with IRS and U.S. Department of Labor filings, along with all other information on how union dues are spent. YES! I want to contribute to AFSCME PEOPLE. Amount to be contributed each pay period through payroll deduction: 1% 1.25% 1.5% 2% Other… Enter other (percentage or dollar amount)… Please check all that apply: New Contributor Increase If you would like a PEOPLE hoodie, please select your size: - None -4XL3XL2XLXLLMS (available with minimum $8.35 monthly contribution) Authorization I hereby authorize my employer and associated agencies to deduct, each pay period, the amount certified as a voluntary contribution to be paid to the treasurer of American Federation of State, County and Municipal Employees PEOPLE, AFSCME, AFL-CIO, P.O. Box 65334, Washington, D.C. 20035-5334, to be used to support pro worker candidates in federal, state, and local elections. My contribution is voluntary, and I understand that it is not required as a condition of membership in any organization, or as a condition of continued employment, and is free of reprisal. I understand that any contribution guideline is only a suggestion and I am free to contribute more or less than that amount and will not be favored or disadvantaged due to the amount of my contribution or refusal to contribute, and that I may revoke this authorization at any time by giving written notice. AFSCME PEOPLE is required by law to make its best efforts to obtain and report the name, address, occupation, and employer of each contributor who gives more than $200 in a calendar year. Contributions or gifts to AFSCME PEOPLE are not deductible as charitable contributions for federal income tax purposes. In accordance with federal law, AFSCME PEOPLE accepts contributions only from AFSCME members, executive and administrative personnel and their families. Contributions from other persons will be returned. Signature Reset My electronic signature is a binding and valid signature. By signing here I agree to all of the terms and conditions set out in this authorization, which apply to my membership, dues payments and, if applicable, PEOPLE payments. YES! I want to commit to help my Local by giving a few hours a month to attend meetings and to advance the Local’s goals. Please have someone contact me to discuss my role in supporting my Local. Sign Your Card
