GAGE Membership Application

GAGE Membership Application and Checkoff Authorization
The Georgetown Alliance of Graduate Employees (GAGE) is a democratic organization built on the idea that we, as graduate workers at Georgetown University, bargain for a better contract for all our members, together. We seek to empower graduate employees and ensure that we have an equal partnership in decisions that shape our future and the future of Georgetown University.

STATUS: Member
Name*
Georgetown University Net ID (e.g. abc123)*
Home Mailing Address
Personal Email (non GU)
example@example.com
Cell Phone*
Degree Program
Degree Department
Job Title and Department
I'd like to get involved! I will:

Talk about GAGE to colleaguesJoin a committeeHost a "Know Your Contract" meeting
Membership Application
I hereby apply for membership in Georgetown Alliance of Graduate Employees - American Federation of Teachers (GAGE, "the Union") and agree to abide by its Constitution and Bylaws. I authorize the Union to act as my exclusive representative in collective bargaining over wages, hours, and other terms and conditions of employment with Georgetown University (GU, "the Employer") My membership in the Union shall be continuous unless I send written notice to the GAGE President that I intend to resign.*

Clear
Signature*
Date

MonthDayYear
Date
Check-off Authorization
I hereby request and voluntarily authorize my Employer, and my Employer's successors, to deduct from my earnings and to pay over to the Union, and its successors, my membership dues or agency fee. This authorization is applicable only when I am employed in a position in the bargaining unit defined in Section 2 of the April 2, 2018 Agreement between the Union and the Employer. This authorization shall remain in effect and shall be irrevocable unless I revoke it by notifying the Union and the Employer's Office of Student Employment in writing. This authorization shall be automatically renewed as an irrevocable check-off when I am employed in a position in the bargaining unit unless I revoke it, regardless of my membership in the Union.*

Clear
Signature*
Date

MonthDayYear
Date
IRS Disclaimer: Payments to the Union are not deductible as charitable donations for federal income tax purposes. However, they may be tax deductible as ordinary and necessary business expenses.

*Telephone Consumer Protection Act Statement: By providing my cell phone number, I understand that the Union may use automated calling technologies and/or text message me on my cell phone on a periodic basis, and that can unsubscribe from these messages.The Union will never charge for text message alerts; carrier message and data rates may apply to such texts.
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GAGE Membership Application and Checkoff Authorization

Membership Application

Check-off Authorization