Skip to main content
Dearborn Federation of Teachers 681 Dues Form
Back to Dashboard
United States of America
- Select -
District of Columbia
US Virgin Island
Newfoundland and Labrador
Prince Edward Island
Billing Zip Code
DPS Employee ID
Select your membership category
Select your membership category
Adult Ed DFT Member
By donating to PAC, we’re able to fight for your pension, good legislation, and elected officials who support you and your professions. Donating to PAC is the most effective way for your voice to be heard.
COPE Amount Values
Bank Account Types
I agree to be a member of Dearborn Federation of Teachers, authorize Dearborn Federation of Teachers to represent me to the fullest extent of the law, and accept the terms of the agreement below.
By providing the information on this form, I authorize Dearborn Federation of Teachers - Local 00681 and the American Federation of Teachers (AFT) to deduct dues for membership per the above information and in accordance with the Dearborn Federation of Teachers - Local 00681 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 Dearborn Federation of Teachers - Local 00681. I agree this authorization remains in effect until terminated in writing by me or until Dearborn Federation of Teachers - Local 00681 is given written notification of my separation from my employer and/or the bargaining unit.
I have read and agree to make the voluntary PAC contributions described below.
PAC DISCLOSURE:I hereby authorize a contribution to the Dearborn Federation of Teachers PAC in the bi-weekly amount indicated above. This authorization is signed freely and voluntarily and not out of any fear of reprisal, and I will not be favored nor disadvantaged because I exercise this right. I understand this money will be used to make political contributions by Dearborn Federation of Teachers PAC. This voluntary authorization may be revoked at any time by notifying Dearborn Federation of Teachers PAC in writing of the desire to do so. Contribution or gifts to Dearborn Federation of Teachers PAC is not deductible as charitable contributions for federal income tax purposes. Contributions cannot be reimbursed or otherwise paid by any other person or entity. Section 55(6) of the Michigan Campaign Finance Act provides that a corporation, a joint stock company, a domestic dependent sovereign, or a labor organization “may solicit or obtain contributions for a separate segregated fund established on an automatic basis, including but not limited to a payroll deduction plan, only if the individual who is contributing to the fund affirmatively consents to the contribution at least once in every calendar year.
Print your name
Draw your signature
Signature field is required
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
1 + 5 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Leave this field blank