AGWA-UAW 1907 Membership Form

AGWA-UAW 1907 Membership Form
Sign up to be a member!

Union membership is how Graduate Workers pool our resources together to enforce our contract and build toward strong union contracts in the future. Only union members can shape the union’s priorities.
Personal Information
First Name
Last Name
UA Email
Preferred Email
UA Campus (Academic)
Department (Academic)
Cell Phone Number
XXX-XXX-XXXX
Mailing Address
Job Information
Job Title
Department (Employment)
Office/Lab Building
Office/Lab Room #
PI/Advisor
Membership Authorization
I hereby request and voluntarily accept membership in UAW and I agree to abide by its Constitution and Bylaws. I know that membership in UAW is voluntary and is not a condition of employment, and that I can decline to join without reprisal.
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Dues and Fees Deduction Authorization
I hereby request and voluntarily authorize the University of Alaska to deduct from my earnings and remit to UAW a one-time initiation fee and an amount equivalent to monthly dues and assessments, as determined by UAW’s Constitution and Bylaws, currently 1.44% of gross pay. Unless revoked, this authorization is to remain in effect for all periods of time inwhich I am a UAW member and receiving a paycheck for work performed in a UAW-represented unit. I understand that this authorization is voluntary and is not a condition of my employment, and I can decline to agree to it without reprisal.
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
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AGWA-UAW 1907 Membership Form

Personal Information

Job Information

Membership Authorization

Dues and Fees Deduction Authorization