Texas AFT Retiree Plus Membership Form

Texas AFT, 912 Highway 183 South, Suite 100-A, Austin, TX, 78741

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First Name *

Middle Name

Last Name *

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Billing Country *

Billing Address *

Billing Suite

Billing City *

Billing State *

Billing Zip Code *

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Mailing Country *

Mailing Address

Mailing Suite

Mailing City

Mailing State

Mailing Zip Code

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Home Phone

Mobile Phone

Preferred Phones

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Personal E-mail *

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I retired as a member of the following Texas AFT local *

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Authorize

Electronic Dues Payment

Through your membership in the Texas AFT Retiree Plus group, you will receive information about issues of significance to retirees and will be supporting important legislative advocacy initiatives pertaining to retirees. Additionally, Texas AFT Retiree Plus group members have access to certain AFT member benefits and discounts, subject to terms and conditions. For more information go to http://www.aft.org/member-benefits. However,membership in Texas AFT Retiree Plus group is not equivalent to being a dues-paying member of Texas AFT or one of its affiliated locals and does not provide members with liability insurance or legal defense.

Authorize COPE

I have read and agree to make the voluntary COPE contributions described below.

COPE DISCLOSURE: I hereby authorize a monthly contribution to the 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. COPE may engage in joint fundraising efforts with AFT COPE and/or the AFL‐CIO. This voluntary authorization may be revoked at any time by notifying COPE in writing of the desire to do so. Contribution or gifts to 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.

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