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UArts Faculty Membership Application and Dues-Check Off Authorization
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UArts Faculty Membership Application and Dues-Check Off Authorization
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First Name
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Middle Name
Last Name
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Mailing Country
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United States of America
Mailing Address
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Mailing City
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Mailing State
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Mailing Zip Code
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Personal E-mail
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Mobile Phone
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UArts Department
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Full Time or Part Time
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Full Time
Part Time
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Title
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First Semester Hired
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UArts Alumni
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Yes
No
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Other Universities I teach at
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Select your membership category
Select your membership category
Union Membership and Authorization Card for UArts
COPE Amount
By donating to COPE, we’re able to fight for your pension, good legislation, and elected officials who support you and your professions. Donating to COPE is the most effective way for your voice to be heard.
COPE Amount Values
$0
$1
$2
$5
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Other Amount
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Authorize 1
Membership Application and Dues Check-Off Authorization:
I hereby apply for membership in United Academics of Philadelphia, AFT-PA, AFT, AFL-CIO, and agree to abide by its Constitution and Bylaws. I authorize the Union, United Academics of Philadelphia, AFT-PA, AFT, AFL-CIO, to act as my exclusive representative in collective bargaining over wages, hours, and other terms and conditions of employment with my Employer. I hereby request and voluntarily authorize my Employer, and my Employer’s successors, to deduct from my earnings and to pay over to the Union, and its successors, my monthly dues or service fee, initiation fees, and assessments. My membership in the Union and dues check-off authorization shall be continuous unless I send written notice by U.S. mail to my Local President that I intend to resign.
Authorize 2
Committee on Political Education (optional):
This Committee on Political Education (COPE) authorization is separate and apart from the above Membership Application and Check-Off Authorization and is attached only for convenience. I hereby voluntarily authorize my employer to deduct from my salary the sum of $__________ per pay period and to forward that amount to the Union’s Committee on Political Education. COPE will use the money contributed to make political contributions and expenditures in connection with federal, state, and local elections. This authorization is not a requirement for union membership or employment, and I am signing it freely and voluntarily. This voluntary authorization may be revoked at any time by notifying the Union in writing of my desire to do so.
Print your name
Date
Date
E.g., 2023-12-06
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