UAW 4121 Membership

UAW 4121 Membership

Our strong majority membership helps us win improvements at UW and beyond
Declare your membership by checking each box to indicate YES to the following*

I accept membership in UAW Local 4121. By signing up for membership I’m helping to make our union stronger and more democratic so we can continue to win improvements.I hereby authorize the University of Washington to deduct from my pay and remit to the union my one-time $10 initiation fee and monthly membership dues in accordance with the UAW Constitution (currently 1.44% of my gross monthly pay). Unless revoked, this authorization is to remain in effect any time I am a UAW member and working in a position represented by UAW 4121. I recognize that my authorization of dues deductions and the continuation of such authorization is voluntary and not a condition of my employment. By checking this box, I agree that my typed name below is the electronic representation of my signature and is legally binding – just the same as a pen-and-paper signature.
I want to get more involved!

Please follow up with me about ways I can get involved and make our union stronger.
Your Info
Name*

First / Preferred NameLast / Family Name
UW Email*
(So we know who you are)
Pronouns
Personal Email*
(So we can stay in touch)
Phone
(So we can stay in touch)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Job Info
Current Job Title
Which position are you currently working in?
Department
Home academic dept (if applicable)
Advisor/PI
If applicable
Month and Year Started
Month/Year in which you started your current degree program, Postdoc, or RSE position
Current Degree Program (if student)
e.g. BA, MA, MS, PhD
Lab/Office Location (Building and Room)
If applicable
Months of Prior Postdoc/RSE Experience Before UW
How many total months did you work as a postdoc/RSE before coming to UW? (For calculating correct pay rate)
Voluntary Community Action Program (VCAP)

Optional Section: Help us Build Power in the Community!
UAW V-CAP (Voluntary Community Action Program) is our union’s fund for political action and supporting candidates who advocate for the issues that directly affect us. This is an important component of our collective ability to influence federal, state and local decision-making bodies to improve conditions for Academic Student Employees (ASEs) and other workers. If you are eligible to vote in the U.S., please contribute and help hold politicians accountable!
Please select your VCAP option*

I am eligible to vote in the US and I want to contribute! Subject to the terms of the collective bargaining agreement, I hereby authorize the University of Washington to withhold each and every paycheck from my earnings, UAW Voluntary Community Action Program (V-CAP) deductions in the following amount and to remit such contribution to UAW V-CAP in the manner agreed upon between the University and the Union at any time while this authorization is in effect.I am not eligible (I can't vote in the US)I don't want to contribute to VCAP right now
Select a Monthly Amount*

$1$2.00 Solidarity Level$6.00 Social Justice Level$25.00 Worker Power LevelOther
This authorization is voluntarily made. I understand that the signing of this authorization and the making of payments to UAW V-CAP are not conditions of membership in the Union or of employment with the University of Washington, that I have the right to refuse to sign this authorization and contribute to UAW V-CAP without any reprisal, and that UAW V-CAP will use the money it receives to make political contributions and expenditures in connection with federal, state and local elections, that all UAW members may be eligible for V-CAP raffle drawings, regardless of whether they make a contribution to UAW V-CAP, and that monies contributed to UAW V-CAP constitute a voluntary contribution to a joint fundraising effort by the UAW and the AFL-CIO. This authorization shall remain in full force and effect until revoked in writing by me. I also understand that the guidelines for contributions to UAW V-CAP set forth above are merely suggestions, that I can contribute more or less than the guidelines suggest, and that the Union will not favor or disadvantage me based on the amount of my contribution or my decision not to contribute. Contributions or gifts to UAW V-CAP are not deductible as charitable contributions for federal tax purposes. All UAW members may be eligible for related raffle drawings, regardless of whether they make a contribution. UAW V-CAP is an independent political committee created by the UAW. This committee does not ask for or accept authorization from any candidate and no candidate is responsible for its activities.
* Last 4 Digits of SSN
To submit the form, make sure you checked both membership boxes up at the top!
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UAW 4121 Membership

Your Info

Job Info

Voluntary Community Action Program (VCAP)