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I want to join with other long-term care workers for a stronger voice for quality care, living wages and good benefits. I hereby request and accept membership in SEIU 775 and I agree to abide by its Constitution and Bylaws. I authorize 775 to act as my exclusive representative in collective bargaining over wages, hours and other terms and conditions of employment with my employer(s).
In exchange for obtaining special benefits through exclusive access to the SEIU 775 Membership Plus Benefits Program, I authorize my employer(s) to deduct from my wages all Union dues and other fees or assessments as shall be certified by 775 under its Constitution and Bylaws and to remit those amounts to 775. This authorization is irrevocable for a period of one year from the date of execution and from year to year thereafter, regardless of my membership status, unless not less than thirty (30) and not more than forty-five (45) days prior to the annual anniversary date of this authorization or the termination of the contract between my employer and the Union, whichever occurs first, I notify the Union and my employer in writing, with my valid signature, of my desire to revoke this authorization. 775 is authorized to use this authorization with my current employer(s) and with any other employer(s) in the event I change employers or obtain additional employment.
I believe everyone should pay their fair share to support our Union’s activities. In order to build a more powerful Union, I hereby knowingly release both SEIU 775 and the State of Washington from any future legal claims or liability related to the State’s past collection of agency fees from me pursuant to CBA Sec. 4.1 and/or RCW 41.56.113.
Contributions or gifts to 775 are not tax deductible as charitable contributions for Federal income tax purposes. However, they may be tax deductible under other provisions of the Internal Revenue Code.
- I am at least eighteen years old.
- I understand that union dues, contributions or gifts to SEIU 775 are not tax deductible as charitable contributions. However, they may be tax deductible as ordinary and necessary business expenses.
- I understand and accept the rights, responsibilities, and benefits of union membership as stated in SEIU 775's bylaws.
By clicking Join, you accept that your printed name, IP address and the date and time will be used as your digital signature.
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