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Jackson Federation of Teachers & School Employees
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Membership Application & Authorization for Payroll Deduction
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First Name
*
Middle Name
Last Name
*
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Mailing Country
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United States of America
Mailing Address
*
Mailing City
*
Mailing State
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Mailing Zip Code
*
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Mobile Phone
Preferred Phones
preferred
Personal E-mail
*
Employer
Worksite Location
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Employee ID Number
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Select your membership category
Select your membership category
Teacher
Support
Dues Amount
$0.00
Total
* draft
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Authorize
I agree to be a member of Jackson Federation of Teachers And School Employees, authorize Jackson Federation of Teachers And School Employees to represent me to the fullest extent of the law, and authorize and request that my employer deduct from my earnings in each pay period the applicable membership dues. I accept the terms of the agreement below.
I hereby apply for and accept membership in the Jackson Federation of Teachers And School Employees. I agree to abide by the Federation’s Constitution and Bylaws and all Rules and Regulations. I authorize the Federation to act as my exclusive representative in collective bargaining over wages, benefits, and other terms and conditions of employment. I hereby authorize and request that you deduct and withhold from my earnings in each pay period the applicable membership dues, and any duly authorized change in that amount, to the Jackson Federation of Teachers And School Employees as prescribed by the Federation’s Constitution and By-Laws, and to remit said dues to the Federation. This authorization is voluntary, and the dues deduction remains in effect from year to year until revoked by me through written notice to my employer, with a copy to the Federation.
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Date
Date
E.g., 2024-10-11
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