Collier County Education Association, Inc. (CCEA) MEMBERSHIP ENROLLMENT FORM

By providing the information on this form, I authorize Collier County Education Association, Inc. - Local 07410 and the American Federation of Teachers (AFT) to deduct dues for membership per the above information and in accordance with the Collier County Education Association, Inc. - Local 07410 constitution, the state constitution and the AFT constitution. Dues payments are not deductible as charitable contributions for federal income tax purposes, but a portion thereof may be deductible as a miscellaneous itemized deduction. The dues amount may change if authorized according to the requirements of the local, state or national constitutions. If this happens, I authorize my bank or credit card to adjust my payment when notified by Collier County Education Association, Inc. - Local 07410. I hereby waive all rights and claims to said monies so deducted, except as noted below, in accordance with this authorization and relieve the School Board and all its officers from any liability therefor. This authorization shall remain in full force and effect for all purposes while I am employed by this school district or until revoked by me upon thirty (30) days advance written notice to the School Board's Business Office and said Association. I agree this authorization remains in effect until terminated in writing by me or until Collier County Education Association, Inc. - Local 07410 is given written notification of my separation from my employer and/or the bargaining unit.