UAW 4591 Membership

Declare your membership by checking each box to indicate YES to the following*

I accept membership in UAW. 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 Washington State University to deduct from my pay and remit to the union my one-time $10 initiation fee and monthly membership dues in accordance with the Constitution (currently 1.44% of my gross monthly pay). Unless revoked in writing, this authorization is to remain in effect any time I am a UAW member and working in a WSU position represented by UAW and its Local Union. I recognize that my authorization of dues deductions and the continuation of such an authorization is voluntary and not a condition of my employment. By checking this box, I agree that my typed name is the electronic representation of my signature and is legally binding – just like pen and paper.

I want to get involved!

Please contact me about ways I can help make my union stronger

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Name*

First/Preferred NameLast Name

WSU Email*

(To verify who you are)

Preferred Email*

(Non-WSU email preferred)

Phone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Current Job Title

Which position are you currently in?

Campus/REC

Department

Your home academic department

Month and Year Started

Month/Year in which you started your current degree program

Current Degree Program

e.g. BS, BA, MA, PhD

Lab/Office Location (Building and Room)

If applicable

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 Washington State University to withhold each and every paycheck from my earnings, UAW Voluntary Community Action Program (V-CAP) deductions in the following amount and to remit suchcontribution to UAW V-CAP in the manner agreed upon between the University andthe Union at any time while this authorization is in effect.I am not eligible (I cannot vote in the US)I don't want to contribute to VCAP right now

Select a Monthly Amount*

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 Washington State University, 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

You need to check both questions at the top to submit this form

UAW 4591 Membership

Personal Information

Job Information

Voluntary Community Action Program (VCAP)