MEMBERSHIP FORM

Education Association of St. Lucie

371 East Midway Road Fort Pierce, FL 34982 (772) 464-6430 Fax: (772) 464-7446 www.easl3616.org

NAME: *

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Instructional, Professional Technical /Specialized: $28.70 pay period Education Support Personnel (including Cafeteria and Custodial Managers): $14.35 pay period

Address: *

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Home Phone: *

Worksite: *

Work Phone Number: *

Home Email: *

example@example.com

School Email: *

example@example.com

Position: *

TIGER-PAC

Would like information on TIGER-PAC (political action committee)

TIGER-PAC (political action committee)

I hereby authorize the Education Association of St. Lucie to deduct the equal amounts as determined by the Association from each remaining payroll check. I understand that the amount deducted from each check will be the same unless changed by the Association or their affiliates, and members will be notified of any dues increases in advance. I hereby waive all rights and claims to said monies and relieve the School Board and all its employees from any liability for the deduction of dues.

I understand that such deductions are continuous and that I may cancel the deduction ONLY after giving thirty (30) days written notice on an official cancellation form to the Association. Cancellation Forms and policies are available from the EASL office.

**NO UNION REPRESENTATION IS PROVIDED FOR INCIDENTS/ACTIONS THAT OCCUR PRIOR TO MEMBERSHIP IN THE EASL

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We are Local # 3616. Our affiliations are with the Florida Education Association (FEA), the American Federation of Teachers (AFT), the National Education Association (NEA), and the AFL-CIO.

Fill out completely and return to the EASL office

MEMBERSHIP FORM

Revised 08/01/2020