University of Pennsylvania

University of Pennsylvania Membership Card

YES! I want to join our union so we can win respect, better wages and a voice on the job.

First Name

Middle Initial

Last Name

Street Address

Apartment, Suite, etc.

City

State

ZIP/Postal Code

Employer

Employee Number

Date of Hire

Occupation/Job Title

Department

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

I hereby apply for membership in the American Federation of State, County and Municipal Employees, District Council 47, Local 590, AFL-CIO (hereafter "AFSCME District Council 47, Local 590" or the "Union") and I agree to abide by its Constitution. By this application I authorize AFSCME District Council 47, Local 590 and any successor or assign to act as my exclusive bargaining representative for purposes of collective bargaining with respect to wages, hours, and other terms and conditions of employment with the University of Pennsylvania.  

Effective immediately, I hereby voluntarily authorize and direct the University of Pennsylvania to deduct from my pay each pay period, regardless of whether I am or remain a member of the Union, the amount of dues certified by AFSCME District Council 47, Local 590 and as they may be adjusted periodically by the Union. I further authorize the University of Pennsylvania to remit such amount monthly to the Treasurer of District Council 47. 

This voluntary authorization and assignment shall be irrevocable, regardless of whether I am or remain a member of the Union, for a period of one year from the date of execution of this authorization or until the termination date of the collective bargaining agreement (if there is one) between the University of Pennsylvania and the Union, whichever occurs sooner, and for the years to come, unless I give the University of Pennsylvania and the Union written notice of revocation during the fifteen (15) days before the annual anniversary date of this authorization, or termination of the collective bargaining agreement. 

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. Payments to AFSCME District Council 47, Local 590 are not deductible as charitable donations for federal income tax purposes. However, state law may extend favored tax treatment.

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.