AFSCME International PEOPLE Card

YES! I want to join AFSCME PEOPLE so that workers can build political power in the USA.

First Name

Middle Initial

Last Name

Street Address

Apartment, Suite, etc.

City

State

ZIP/Postal Code

Employer

Employee Number

Occupation/Job Title

Department

Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation and name of employer of individuals whose contributions exceed $200 in an election cycle.

	Pay Frequency
Every Two Weeks/Twice A Month	Every Two Weeks/Twice A Month
Every Week	Every Week
Monthly	Monthly

Please select your pay frequency.

Contribution

Please enter the amount you would like to contribute each pay period. If you are paid weekly or monthly, please change your amount accordingly.

Jacket Size

Please enter your desired jacket size. (Sizes: S to 4XL)

Personal Email

Cell Phone †

† By providing my cell phone number I consent to receive calls (including recorded or autodialed calls, or texts) at that number from AFSCME and its affiliated labor, political and charitable organizations on any subject matter. My carrier’s rates may apply. I may modify my preferences by calling the Union at 215-893-3731 or emailing the Union at support@dc47.org.

Authorization

For voluntary PEOPLE deduction authorization: I hereby authorize my employer and associated agencies to deduct, each pay period, the amount certified in the box provided as voluntary contribution to be paid to the treasurer of American Federation of State, County, & Municipal Employees PEOPLE, AFL-CIO, P.O. Box 65334, Washington, D.C. 20035-5334, to be used for the purpose of making political contributions and expenditures. My contribution is voluntary, and I understand that it is not a required as a condition of membership in any organization, or as a condition of continued employment, and is free of reprisal. I understand that any contribution guideline is only a suggestion and I am free to contribute more or less than that amount and will not be favored or disadvantaged due to the amount of my contribution or refusal to contribute, and that I may revoke this authorization at any time by giving written notice.

Contributions or gifts to AFSCME PEOPLE are not deductible as charitable contributions for federal income tax purposes. In accordance with the federal law, AFSCME PEOPLE will accept contributions only from members of AFSCME and their families. Contributions from other persons will be returned.

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.