Kansas University Nurses Association (KUNA) Membership Form

By providing the information on this form, I authorize the American Federation of Teachers-Kansas (AFT-Kansas) and the American Federation of Teachers (AFT) to deduct monthly dues for membership in accordance with the Kansas University Nurses Association, AFT-Kansas constitution, the AFT-Kansas 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 monthly 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 Kansas University Nurses Association - Local 05132 or AFT-Kansas. I agree this authorization remains in effect until terminated in writing by me.

KAPE COPE DISCLOSURE: I hereby authorize a monthly contribution to the Kansas Association of Public Employees Committee on Political Education (KAPE COPE) in the 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. This voluntary authorization may be revoked at any time by notifying AFT-Kansas in writing of the desire to do so. Contribution or gifts to KAPE COPE are not deductible as charitable contributions for federal income tax purposes. Contributions cannot be reimbursed or otherwise paid by any other person or entity. Candidates may include individuals running for boards of education, city or county offices, the state legislature and other offices.