SEIU 775

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*By providing my phone number, I understand 775, SEIU and affiliates may use automated calling technologies and/or text message me on my cell phone on a periodic basis. 775, SEIU and affiliates will never charge for text message alerts. Carrier message and data rates may apply to such alerts. Text STOP to 787753 to stop receiving messages or HELP to 787753 for more information.

JOIN OUR MOVEMENT

Yes! I want to join with other long-term care workers for a stronger voice for quality care, living wages and good benefits and become a member of SEIU 775 (“Union”). I request and voluntarily accept membership in SEIU 775. This means I will receive the benefits and abide by the obligations of membership set forth in the Constitution and Bylaws of both SEIU 775 and the Service Employees International Union (“SEIU”). I authorize SEIU 775 to act as my representative in collective bargaining over wages, hours, benefits and other terms and conditions of employment with my current employer(s) and any subsequent employer(s) within the Union’s jurisdiction, and their successor(s), and as my exclusive representative, where authorized by law. I know that membership in the Union is voluntary and is not a condition of employment, and that I can decline to join without reprisal. I acknowledge that failure to pay my dues on a timely basis may affect my membership standing in the Union, as set forth in the SEIU 775 Constitution and Bylaws.

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MAINTAIN OUR STRENGTH

In exchange for obtaining the rights and privileges of union membership, and special benefits through exclusive access to the SEIU 775 Membership Plus Benefits Program, I request and voluntarily authorize my employer(s) to deduct from my wages an amount equal to all Union dues and other fees or assessments as shall be certified by SEIU 775 under its Constitution and Bylaws and to remit those amounts to SEIU 775. This authorization shall remain in effect unless I revoke it by sending written notice to SEIU 775, with my valid signature, of my desire to revoke this authorization during the periods not less than 15 days and not more than 45 days before either (1) the annual anniversary date of this agreement, or (2) the date of termination of the applicable collective bargaining agreement between my employer and the Union. This authorization shall be automatically renewed from year to year unless I revoke it during a window period, even if I have resigned my membership. SEIU 775 is authorized to use this authorization with my current employer(s), and any subsequent employer(s) and their successor(s), and with any other employer(s) in the event I change employers or obtain additional employment. This authorization is voluntary and is not a condition of my employment, and I can decline to agree to it without reprisal. I understand that all members benefit from everyone’s commitments because they help build a strong union that is able to plan for the future.

Contributions or gifts to SEIU 775 are not tax deductible as charitable contributions.

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Hold Politicians Accountable

Yes! I want to hold politicians accountable to working families and I know we can only do that if we stand together. I hereby authorize my employer(s) to withhold the indicated amount per month to forward to SEIU 775 (“Union”) as a contribution to SEIU Committee on Political Education (“COPE”). If I do not choose one of the amounts below, or write in a different amount, I agree to a $10.00 per month deduction. My signature shows that I agree with this term and the terms below.

This authorization is made voluntarily based on my specific understanding that: (1) I am not required to sign this form or make voluntary contributions to COPE as a condition of my employment or membership in the union; (2) I may refuse to contribute without reprisal; (3) under law, only union members and executive/ administrative staff who are U.S. Citizens or lawful permanent residents are eligible to contribute to COPE; (4) the contribution amounts on this form are merely suggestions, and I may contribute more or less by this or other means without fear or disadvantage from SEIU or my employer(s); (5) COPE uses the money it receives for purposes including but not limited to making contributions to and expenditures on behalf of candidates for federal offices. This authorization shall remain in effect until revoked by me in writing to SEIU 775 via U.S. mail.

Contributions or gifts to SEIU COPE are not tax deductible as charitable contributions.

Other amount: $

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