SEIU 775 Caregiver Info Material Order Form

Most orders take 5-10 business days to process and will be shipped via UPS. (Individual contracts may be sent via the US Postal System.)

If you do not receive your materials within 14 business days, please email our Member Resource Center at mrc@seiu775.org.

MATERIALS AVAILABLE:

CDWA New Employee Orientation (NEO) packet:
- One English membership form
- One English Collective Bargaining Agreement (CBA) with Consumer Direct WA
- One WA voter registration card
Agency New Employee Orientation (NEO) packet:
- One English membership form
- One English Collective Bargaining Agreement (CBA)
- One of each of the SEIU 775 Benefits Group Training flyers: Basic Training, Continuing Education, Health Benefits, and Secure Retirement Plan
SEIU 775 Membership Forms (available in English, Spanish, Russian, Simplified Chinese, Vietnamese, and Korean)
Collective Bargaining Agreement (CBA)
SEIU 775 Benefits Group information including: The Caregiver Handbook, a Basic Training flyer, a Continuing Education flyer, a Carina flyer, a Health Benefits flyer, and a Secure Retirement Plan flyer
- Please note that these materials will be shipped separately by the SEIU 775 Benefits Group
- All SEIU 775 Benefits Group material have a minimum order of 25 per item.

1. Name (Who is placing this order)*

First NameLast Name

2. Name (Recipient of ordered material, if different than above)

First NameLast Name

3. Address (where to mail ordered material)*

Street Address

Street Address Line 2

CityState

Zip Code

4. Your Phone Number

5. Your Email*

example@example.com

6. Your Affiliation*

7. Select your employer/contract name. *

This will ensure we send you the right contract and ensure we pre-print the correct Employer on any membership forms you request. (For example, if you work for CDWA or are a CDWA caregiver, you should select, "WA - Consumer Direct WA / State of WA").

8. How many NEO packets do you need? (CDWA and Agencies only)

See above for what's included.

9. Full Collective Bargaining Agreement: How many copies of the full CBA of the previously selected employer would you like to order? This is in addition to any NEO packets, if you order those. | Note: Not all CBAs have been translated ahead of time, an additional 3-4 weeks may be required for translation and then printing of any translated CBAs. All current translations of CBAs are available on our Contracts page. If you would like to request CBAs in languages not listed, please add what languages into the “Comments/questions” box below and we will evaluate the request before confirming with you via email.

	Quantity
English
Spanish
Russian
Simplified Chinese
Korean
Vietnamese

10. Membership Forms: How many copies of our Membership Form would you like to order? This is in addition to any NEO packets, if you order those.

	Quantity
English
Spanish
Russian
Simplified Chinese
Korean
Vietnamese

11. SEIU 775 Benefits Group flyers and Caregiver Handbook: How many copies of the below flyers or handbook would you like to order? (CDWA and Agencies only). | Note: At this time, these are only available in English. Orders of SEIU 775 Benefits Group flyers and the Caregiver Handbook will be fulfilled by the SEIU 775 Benefits Group and may be shipped separately. A minimum order of 25 per item you want is required.

	Quantity
Caregiver Handbook
Basic Training flyer
Continuing Education flyer
Health Benefits flyer
Secure Retirement Plan flyer
Carina flyer

12. Comments/questions