Union Card

First Name

Last Name

Street Address

Apartment, Suite, etc.

City

State

ZIP/Postal Code

Date of Birth

Personal Email

Work Phone

Cell Phone †

† By providing my cell phone number, I consent to receive calls/text messages from RI Council 94, AFSCME, AFL-CIO, AFSCME International or the Local Union and know my carrier rates may apply. I may opt-out or change my preferences by calling the Union at 401-724-5900.

Employer

Employee ID Number

Local Number

Date of Hire

Authorization

I, the undersigned, hereby request and accept voluntary membership in RI Council 94, AFSCME, AFL-CIO (Union) and agree to abide by its Constitution and/or By-laws.  Effective immediately, I hereby voluntarily authorize and direct my Employer to deduct from my pay, each pay period, an amount sufficient to provide for regular payment of Union dues, as established by RI Council 94, AFSCME, AFL-CIO or the Local Union, including any periodic adjustments,  and remit such amount to RI Council 94, AFSCME, AFL-CIO regularly.  This voluntary authorization shall remain in full force and effect unless and until I give RI Council 94, AFSCME, AFL-CIO a written revocation of such membership.

Signature

My electronic signature is a binding and valid signature. By signing here I agree to all of the terms and conditions set out in this authorization, which apply to my membership, dues payments and, if applicable, PEOPLE payments.