URA-AFT Committee on Political Education (COPE) Donor Authorization Form

Join the Committee on Political Education (COPE) to support worker-friendly candidates & policies in Washington & Trenton

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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 *

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Personal E-mail *

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Sign me up for political action alerts via email and or text messages

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I am willing to volunteer for:

Voter registration events

Citizenship Days

Getting out the vote for union-endorsed candidates

Other actions

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COPE Amount

Other Amount

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Authorize COPE

I hereby authorize and direct Rutgers, The State University to make biweekly deductions from my pay in the following amount and remit that amount to the Union of Rutgers Administrators-American Federation of Teachers, 1766 COPE fund.

Contributions or gifts to the URA-AFT COPE are not deductible as charitable contributions for federal income tax purposes. The payroll deduction suggested by URA-AFT is not sponsored or endorsed in any way by Rutgers, The State University or by anyone on its behalf, or by the State of New Jersey. Rutgers makes no promises or representations of any kind whatsoever concerning this payroll deduction. This authorization is signed freely and voluntarily and not out of any fear of reprisal, and I not be favored nor disadvantaged because I exercise this right. I understand this money will be used to make political contributions by URA-AFT COPE. URA-AFT COPE may engage in joint fundraising efforts with the AFL-CIO. This voluntary authorization may be revoked at any time by notifying the URA-AFT COPE in writing of the desire to do so.

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