Join United Campus Workers Utah

Join United Campus Workers Utah

Communications Workers of America Local 7765
Membership Information
Name*

First NameLast Name
Personal Email *
We will use this to contact you
Phone Number*
Please enter a valid phone number.
Pronouns (optional)
Institutional Email
We will NOT use this to contact you, we use this for data quality purposes.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employment Information
Employee type (select all that apply)*

Undergraduate StudentGraduate StudentInstructorLecturerResearcherPost-doctoral researcherFacultyStaffRetireeAdjunctFormer employeeTenuredTenure TrackNon-Tenure TrackResident Advisor/AssistantTeaching FacultyTeaching AssistantResearch AssistantOther
University*

University of UtahUtah State University
Department (old)
College
Department*
Building
Where your primary office/workplace/lab/etc. is located
Job Title*
Can we text you?*

YesNo
How did you hear about UCW Utah?
e.g. who you spoke to, or where
How did you hear about UCW Utah?*

FlyerEvent/tablingSocial media/newsGoogle/search engineNewsletter/emailWord of mouthPrefer not to answerOther
What is the name of the person who informed you of UCW Utah?
This field is optional, but allows you to give a shout-out to your coworker or organizer!
What issues are you interested in? (select all that apply)

Student feesStipends/wages/salariesInternational student experienceSupportAdvisor/PI/Supervisor issuesMental healthCost of living / food insecurityCampus climate / safetyWork loadCoronavirusDiversityDiscriminationAccessibilityHealthcare/InsuranceChildcare/Support for ParentsInternational student issuesPublic funding for higher edOutreach/union membershipRespect/RecognitionLegislative and Political EngagementMutual aidLGBTQ+ justiceRacial JusticeAcademic FreedomParkingTransparencyInput on department and/or university policy/decision-makingOther
Can we contact you about volunteering as an organizer?

YesNo
How did you hear about UCW Utah? (old)

Union 101UCWU SocialUCWU RallyCoworkerA UCW MemberFlyerOther
Membership Dues and Donations
Select Your Income Bracket*

Under $20k/year: $10/month$20-35k/year: $12/month$35-50k/year: $20/month$50-65k/year: $25/month$65-80k/year: $30/monthAbove $80k/year: 1% of income
What is your annual salary from the university you work at?($)*
Monthly Membership Dues
Monthly Membership Dues ($)
Dues are paid in monthly installments and begin the day you register.
Optional Donations

(Not tax deductible)
Political Action Fund (optional): Contribute to CWA's political action fund to increase our influence in national, state, and district electoral struggles. See www.cwa-union.org/cwa-political-action-fund.

None$5/month$10/month$15/monthOther
UCWU Mutual Aid Fund (optional): Add a donation to our mutual aid fund which assists UCW members with financial insecurity.

None$1/month$5/month$10/monthOther
CWA 7765 General Fund (optional): Add an additional monthly donation to the union's general fund.

None$1/month$5/month$10/monthOther
$1 to cover transaction fees (optional): Add an optional $1 to your monthly contribution to help cover transaction fees. This frees up more of our funds for building our union.

None$1/month
Monthly dues plus optional donations ($)
Dues and Donations
Membership Dues Authorization
I authorize the deduction from my bank account using my debit/credit card for membership dues to CWA 7765. I understand that I may revoke this authorization at any time by written notice to finance@cwa7765.org.*

Check to authorize

Check Out*

Contributions

Sum of monthly membership dues and optional donations.

USD for each month

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Join United Campus Workers Utah

Membership Information

Employment Information

Membership Dues and Donations

Optional Donations

Membership Dues Authorization