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personal-information-1
First Name
*
Middle Name
Last Name
*
billing-address
Mailing Country
*
United States of America
Mailing Address
*
Mailing Suite
Mailing City
*
Mailing State
*
- Select -
Alabama
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Connecticut
Delaware
District of Columbia
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Texas
Utah
Vermont
Virginia
US Virgin Island
Washington
West Virginia
Wisconsin
Wyoming
Mailing Zip Code
*
personal-information-2
Mobile Phone
Preferred Phones
preferred
Personal E-mail
*
custom-field-1
Opt in for text messages
*
Yes
No
custom-field-2
Agency
*
custom-field-3
Work Location
*
custom-field-4
Title
*
custom-field-5
State Employee #
*
payroll-deduction
membership-wrapper
Select your membership category
Select your membership category
AMECSS MEMBER
Dues Amount
$0.00
Total
* draft
privacy-policy
legal-wrapper
Authorize
YES! I want to join with my colleagues and become a member of AFT Connecticut. I agree to abide by its Constitution and Bylaws and I will stand with AFT Connecticut as we fight for a voice in our workplace as managers in state service.
I hereby authorize you, the state of Connecticut, to deduct from my paycheck such amounts as may from time to time be authorized by AFT Connecticut membership dues. The amount so deducted is to be forwarded to the AFT Connecticut for my credit. I have been informed that I may cancel this authorization upon 30 days written notice to AFT Connecticut.
Print your name
Date
Date
E.g., 2024-10-11
Signature field is required
CAPTCHA
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Math question
*
7 + 13 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
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