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St. Martin Federation of Teachers & School Employees
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Membership Form & Authorization for Payroll Deduction
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First Name
*
Middle Name
Last Name
*
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Mailing Country
*
United States of America
Mailing Address
*
Mailing City
*
Mailing State
*
- Select -
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
US Virgin Island
Washington
West Virginia
Wisconsin
Wyoming
Mailing Zip Code
*
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Mobile Phone
Preferred Phones
preferred
Personal E-mail
*
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Employee ID Number
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Work Location (i.e. school name)
*
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Referred by
payroll-deduction
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Select your membership category
Select your membership category
Teacher
Support
Dues Amount
$0.00
Total
* draft
privacy-policy
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Authorize
I agree to be a member of St. Martin Federation of Teachers and School Employees, authorize St. Martin 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 St. Martin 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 St. Martin 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.
Print your name
Date
Date
E.g., 2024-11-22
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