WFSE Member Card

When we work together, we are unstoppable. History has shown that when we stand together as a union, we can build a better future for our communities, our families, and our jobs. Union membership matters. ______________________________________________________ • Fair Pay • Affordable Health Care • Retirement Security • Preserving Public Services ______________________________________________________ This is an official Payroll Deduction Authorization form for union dues. Payments to the union are not deductible as charitable donations for federal income tax purposes.
Learn more about union membership at www.wfse.org

MEMBERSHIP CARD FORM

Member Information
First Name*
Middle Initial
Last Name*
Nickname
Date of Birth
Gender
Other language used at home
Contact Information
Address
Zip Code
City
State
Mailing Address
Mailing Zip Code
Mailing City
Mailing State
Cell Phone
Home Email*
Home Phone
Work Phone
Work Email*
Job Information
Employer*
Job Class/Title
Work City*
Work County
Employee ID #*
Date Hired into Position
Select your Work Shift
YES! I want to be a union member. I support advocating for quality services and good jobs. I understand that as a WFSE member I will help make our union stronger to protect public services and work together to improve pay, benefits and working conditions for all public employees. Effective immediately, I hereby voluntarily authorize and direct my Employer to deduct from my pay each pay period, an amount equivalent to dues as set in accordance with the Washington Federation of State Employees (WFSE) Constitution and By-Laws and authorize my Employer to remit such amount semi-monthly to the Union (currently 1.5% of my salary per pay period not to exceed the maximum). This voluntary authorization and assignment shall be irrevocable for a period of one year from the date of execution or until the termination date of the collective bargaining agreement (if there is one) between the Employer and the Union, whichever occurs sooner, and for year to year thereafter unless I give the Employer and the Union written notice of revocation prior to the end of any yearly period, regardless of whether I am or remain a member of the Union, unless I am no longer in active pay status in a WFSE bargaining unit; provided however, if the applicable collective-bargaining agreement specifies a longer or different revocation period, then only that period shall apply. This card supersedes any prior check-off authorization card I signed. I recognize that my authorization of dues deductions, and the continuation of such authorization from one year to the next, is voluntary and not a condition of my employment.