TUGSA Full Member Membership Form

TUGSA Full Member Membership Form
Temple University Graduate Students' Association (TUGSA)

American Federation of Teachers, Local #6290

Phone Number: 215-587-6786 E-mail Address: union@tugsa.org

Yes! I support my colleagues in our efforts to build a strong union. I hereby become a member of the Temple University Graduate Students' Association, and I authorize TUGSA to be my exclusive representative for the purposes of collective bargaining with Temple University.

I am aware that I may cancel my membership in the union at any time by sending a written notice to TUGSA but that my dues authorization will remain in full force and effect until revoked by me in writing to both TUGSA and the Temple Labor Relations Office during the ten (10) business days preceding the expiration of a semester. For more information, I understand that I can contact union@tugsa.org to request instructions on terminating my membership.
Name *

First Name Last Name
Personal Email Address (NOT Temple Related) *

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number (Personal) *

Area Code Phone Number
Phone Number (Business or Campus)

Area Code Phone Number
Name of College & Department (in which you are a student) *
Name of College & Department (in which you are employed) *
Please Select Graduate Student Year *
Expected Date of Graduation
Select Position *
Please Indicate Assistantship Status: *

Temple University

Human Resources

Office Labor Relations

I, the undersigned, a member of TUGSA, authorize Temple University to deduct all dues payments authorized by the TUGSA Constitution and Bylaws from my pay and to remit the amount so deducted to TUGSA, while I am employed in a bargaining unit position.

This authorization will remain in full force and effect until revoked by me, in writing. Such revocation must be a written notice sent to TUGSA and the Temple Labor Relations Office during the ten (10) business days preceding the expiration of a semester.

As of June 1, 2004, the TUGSA Bylaws set dues at 1.65% of income from employment within the bargaining unit. Dues levels are established by the membership and are subject to change according to procedures defined in Article Thirteen of the TUGSA Constitution. Copies of the TUGSA Constitution and Bylaws are available at the TUGSA office or online at http://www.tugsa.org.
Name *
Name of College & Department (in which you are employed) *
Temple University ID (Student ID) *
Signature *
Date of Application *
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm