Join United Campus Workers Utah
Communications Workers of America Local 7765
Membership Information
Name
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First Name
Last Name
Personal Email
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Institutional Email
We will NOT use this to contact you, we use this for data quality purposes.
Phone Number
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Please enter a valid phone number.
Pronouns (optional)
Address
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Street Address
Street Address Line 2
City
State / Province
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Employment Information
Employee type (select all that apply)
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Undergraduate Student
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Instructor
Lecturer
Researcher
Post-doctoral researcher
Faculty
Staff
Retiree
Adjunct
Former employee
Tenured
Tenure Track
Non-Tenure Track
Resident Advisor/Assistant
Teaching Faculty
Teaching Assistant
Research Assistant
Other
University
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University of Utah
Utah State University
Department
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Please Select
Accounting
Aerospace Studies
Alumni Services
Anesthesiology
Anthropology
Architecture
Art & Art History
Asian Studies
Athletics
Atmospheric Sciences
Biochemistry
Biomedical Engineering
Biology
Biomedical Informatics
Book/ Campus Store
Chemical Engineering
Chemistry
City & Metropolitan Planning
Civil & Environmental Engineering
Communication
Communication Sciences &
DEI
Disorders
Computing
Continuing Education
Dance
Dental Education
Dermatology
Dining Services
Economics
Education, Culture & Society
Educational Leadership & Policy
Educational Psychology
Electrical & Computer Engineering
English
Entrepreneurship & Strategy
Environmental Engineering
Exercise & Sport Science
Facilities
Family & Consumer Studies
Family & Preventive Medicine
Film & Media Arts
Finance
Geography
Geology & Geophysics
Health, Kinesiology & Recreation
History
Human Genetics
Human Resource
Internal Medicine
International Studies
International Office
IT
Latin American Studies
Law
Library
Linguistics
Management
Marketing
Materials Science & Engineering
Mathematics
Mechanical Engineering
Medical Laboratory Sciences
Medicinal Chemistry
Metallurgical Engineering
Military Science
Mining Engineering
Molecular Pharmaceutics
Multi-disciplinary Design
Music
Naval Science
Neurobiology & Anatomy
Neurology
Neurosurgery
Nursing
Nutrition and Integrative Physiology
Obstetrics & Gynecology
Occupational and Recreational Therapies
Oncological Sciences
Operations & Information Systems
Ophthalmology
Orthopaedics
Parking Enforcement
Parks, Recreation & Tourism
Pathology
Pediatrics
Pharmacology & Toxicology
Pharmacotherapy
Pharmacy Services
Philosophy
Physical Medicine & Rehabilitation
Physical Therapy & Athletic Training
Physics & Astronomy
Physiology
Political Science
Population Health Sciences
Psychiatry
Psychology
Radiation Oncology
Radiology
Security
Social Work
Sociology
Special Education
Surgery
Theatre
Training & Development
Undergraduate Studies
World Languages & Cultures
Writing and Rhetoric
OTHER
College
*
Please Select
Architecture + Planning
Business
Cultural & Social Transformation
Dentistry
Education
Engineering
Fine Arts
Graduate School
Health
Honors College
Humanities
Law
Medicine
Mines & Earth Sciences
Nursing
Pharmacy
Science
Social & Behavioral Science
Social Work
OTHER
Please specify "other"
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If you are unable to find your department or college that is appropriate to your role please specify here.
Building
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Where your primary office/workplace/lab/etc. is located
Job Title
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Contact Preferences
What issues are you interested in? (select all that apply)
Student fees
Stipends/wages/salaries
International student experience
Support
Advisor/PI/Supervisor issues
Mental health
Cost of living / food insecurity
Campus climate / safety
Work load
Coronavirus
Diversity
Discrimination
Accessibility
Healthcare/Insurance
Childcare/Support for Parents
International student issues
Public funding for higher ed
Outreach/union membership
Respect/Recognition
Legislative and Political Engagement
Mutual aid
LGBTQ+ justice
Racial Justice
Academic Freedom
Parking
Transparency
Input on department and/or university policy/decision-making
Other
Can we contact you about volunteering as an organizer?
Yes
No
Can we text you?
Yes
No
How did you hear about UCW Utah?
Union 101
UCWU Social
UCWU Rally
Coworker
A UCW Member
Flyer
Other
Please provide details about the above event(s) or conversation(s)
e.g. who you spoke to, or where
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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/month
Above $80k/year: 1% of income
What is your annual salary from the university you work at?($)
*
Monthly Membership Dues ($)
Dues are paid in monthly installments and begin the day you register.
Monthly Membership Dues
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/month
Other
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/month
Other
CWA 7765 General Fund (optional): Add an additional monthly donation to the union's general fund.
None
$1/month
$5/month
$10/month
Other
$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
$1/month
Monthly dues plus optional donations ($)
Monthly Contributions
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Membership Dues Authorization
I authorize the deduction from my bank account for membership dues to CWA 7765. I understand that I may revoke this authorization at any time by written notice to finance@cwa7765.org.
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Check to authorize
Signature
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