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United Falcons of UW River Falls/AFTW, Local 6504
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personal-information-1
First Name
*
Middle Name
Last Name
*
billing-address
Billing Country
*
United States of America
Billing Address
*
Billing Suite
Billing City
*
Billing State
*
- Select -
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
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Hawaii
Idaho
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Iowa
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Kentucky
Louisiana
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Maryland
Massachusetts
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Mississippi
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New Hampshire
New Jersey
New Mexico
New York
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North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Billing Zip Code
*
also mailing address
Mailing Country
*
United States of America
Mailing Address
Mailing Suite
Mailing City
Mailing State
mailing state
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
Washington
West Virginia
Wisconsin
Wyoming
Mailing Zip Code
personal-information-2
Home Phone
Mobile Phone
Work Phone
Preferred Phones
preferred
preferred
preferred
Personal E-mail
*
Work E-mail
Work Location
membership-payment
membership-wrapper
Select your membership category
Select your membership category
Annual Salary-$16,164 to $33,999_Half Dues
Annual Salary-$34,000 and up_Full Dues
Dues Amount
$0.00
Total
* draft
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
$20
$10
$5
other
Other Amount
Payment Methods
bank draft
credit/debit card
account type
Credit Card Types
Visa
Master Card
Name on Card
Card Number
Card Expiration Date
Month
-Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Year
-Year
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
Card Security Code
Where Is My CVV Number?
For most cards the Card Security code is printed on the signature strip on the back of the credit card. The value will be the last 3-4 digits of the printed number.
account type
Bank Account Types
checking
saving
Bank Name
Routing Number
Account Number
privacy-policy
legal-wrapper
Authorize
I agree to be a member of (insert local), authorize (insert local) to represent me to the fullest extent of the law, and accept the terms of the agreement below.
I authorize (INSERT LOCAL NAME AND NUMBER) and American Federation of Teachers (AFT) to draft my account each month for the amount indicated above. The monthly dues amount include local, state, or national constitutions. If this happens, I authorize my bank to adjust my monthly payment when notified by (INSERT LOCAL NAME AND NUMBER). I agree this authorization remains in effect until terminated in writing by me. I understand that union dues may not be deductible for federal income tax purposes; however, under limited circumstances, dues may qualify as a business expense.
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 INSERT COPE ENTITY NAME 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. INSERT COPE ENTITY NAME 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 INSERT COPE ENTITY NAME in writing of the desire to do so. Contribution or gifts to INSERT COPE ENTITY NAME are not deductible as charitable contributions for federal income tax purposes. Contributions cannot be reimbursed or otherwise paid by any other person or entity.
Print your name
Date
Date
E.g., 2021-01-24
Signature field is required
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