MEMBERSHIP CARD FORM

WFSE Member Card - Interpreters

Note to L&I Interpreters: On September 14, 2023, we officially won certification of our union! We need strong membership numbers to get the best possible contract. Filling out this membership card ensures you will have a say in what's in our contract, who is on our bargaining team, and whether or not you accept the contract. No dues will be collected for L&I jobs until after L&I interpreters accept the contract and the contract takes effect. Dues will be just 1.5% of your L&I pay. Already a member of Interpreters United (WFSE) Local 1671? If you take L&I jobs, you still need to fill out this membership card to ensure you can have a say in bargaining and accepting our L&I contract. Take DSHS, HCA, DCYF appointments? Fill out this membership card to become a WFSE member today. ______________________________________________________ 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. ______________________________________________________ This is an official Payroll Deduction Authorization form for union dues. Signing a membership card is a commitment to pay dues for one year to keep your union strong. 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

BY PROVIDING YOUR CELL PHONE NUMBER, YOU CONSENT TO RECEIVE CALLS (INCLUDING RECORDER OR AUTODIALED CALLS, OR TEXTS) AT THAT NUMBER FORM THE UNION AND ITS AFFILIATES ON A PERIODIC BASIS. THE UNION WILL NEVER CHARGE FOR TEXT MESSAGE ALERTS. YOUR CARRIER'S RATES MAY APPLY. YOU MAY MODIFY YOUR PREFERENCE BY EMAILING THE WFSE MEMBER CONNECTION CENTER (MCC) AT [email protected] OR BY CALLING THE MCC AT 833-MCC-WFSE (833-622-7373)

Cell Phone

Home Email*

Home Phone

Work Phone

Work Email*

Job Information

With which of the following Agencies do you take appointments? Check all that apply.

DCYF

DSHS

HCA

LNI

Employer*

Job Class/Title

Work City*

Work County

Employee ID #

Date Hired into Position

Select your Work Shift

YES! I want to join Interpreters United/The Washington Federation of State Employees (WFSE) to win dignity and respect for our profession! By checking the box, I agree that my typed name is the electronic representation of my signature and is legally binding -- just like pen and paper. Effective immediately or upon execution of a collective bargaining agreement that covers the terms and conditions of my employment, I hereby voluntarily authorize and direct my payroll administrator 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 payroll administrator to remit such amount semi-monthly to the Union (currently 1.5% of my salary per pay period not to exceed the maximum, capped at $125.66 per month as of July 1, 2024). This voluntary authorization and assignment shall be irrevocable for a period of one year from the date of execution and automatically renews year to year thereafter unless I give 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 status in a WFSE bargaining unit. 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 ability to perform language access services.