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UFF-PHSC Membership Form
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personal-information-1
First Name
*
Middle Name
Last Name
*
billing-address
Mailing Country
*
United States of America
Mailing Address
*
Mailing Suite
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
Work Phone
Preferred Phones
preferred
preferred
Personal E-mail
*
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Department
*
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Title
*
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Campus/Office
*
payroll-deduction
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Select your membership category
Select your membership category
Full Dues
Dues Amount
$0.00
Total
* draft
privacy-policy
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Authorize 1
I want to join my colleagues by becoming a member of the United Faculty of Florida, NEA, AFT, FEA, AFL-CIO, and my local UFF chapter.
I hereby request and voluntarily accept membership in the United Faculty of Florida, NEA, AFT, FEA, AFL-CIO, and my local UFF chapter, and agree to abide by the Constitution and Bylaws of all organizations.
Authorize 2
I authorize payment by Pasco-Hernando State College to deduct from my pay in each pay period a pro-rata portion of the annual dues.
Annual dues are one percent of my regular salary and include all fees and assessments required for membership in the United Faculty of Florida, NEA, AFT, FEA, AFL-CIO, and my local UFF chapter. This authorization continues annually regardless of my membership status, unless (a) I revoke this authorization upon 30 days’ notice in writing sent via email, fax or US mail to the employer and employee organization according to Florida Statue 447.303, or (b) my employment with Pasco-Hernando State College ends. I UNDERSTAND THAT THIS AGREEMENT IS VOLUNTARY AND IS NOT A CONDITION OF EMPLOYMENT, AND THAT I HAVE THE LEGAL RIGHT TO REFUSE TO SIGN THIS AGREEMENT WITHOUT SUFFERING ANY REPRISAL.
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Date
Date
E.g., 2023-09-22
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