Membership Application Authorization of Dues Withholdings

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First Name *

Middle Name

Last Name *

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Mailing Country *

Mailing Address *

Mailing Suite

Mailing City *

Mailing State *

Mailing Zip Code *

also billing address

Billing Country *

Billing Address

Billing Suite

Billing City

Billing State

Billing Zip Code

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Home Phone

Mobile Phone

Preferred Phones

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Personal E-mail *

Work E-mail

Work Location

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employee id *

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employer *

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position *

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Select your membership category

privacy-policy

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Authorize

I agree to be a member of AFT Utah, authorize AFT Utah to represent me to the fullest extent of the law, and accept the terms of the agreement below.

I hearby authorize my employer to withhold from my salary a sum equal to the annual dues of AFT Utah as determined by my local assignee. This authorization will remain in effect until further notice - unless changed or terminated by me on thirty days written notice to AFT Utah. Dues paid to AFT Utah may not be deductible for federal income tax purposes; however, under limited circumstances, dues may qualify as a business expense. These dues shall be deducted monthly in equal payments. I understand my dues will provide liability and Accidental Death & Dismemberment insurance, as well as all related AFT publications and union benefits.

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