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YES, I’m ready to unite and build a better future for the EMS profession.

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Apartment, Suite, etc.

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Employer

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Cell Phone †

† By providing my cell phone number I consent to receive calls (including recorded or autodialed calls, or texts) at that number from AFSCME and its affiliated labor, political and charitable organizations on any subject matter. My carrier’s rates may apply. I may modify my preferences at https://www.afscme.org/tcpa.

By providing my cell phone number I consent to receive calls (including recorded or autodialed calls, or texts) at that number from AFSCME and its affiliated labor, political and charitable organizations on any subject matter. My carrier’s rates may apply.

Authorization

I, the undersigned, hereby designate the American Federation of State, County and Municipal Employees, Local 360, AFL-CIO, as my duly chosen and authorized representative on matters relating to my employment in order to promote and protect my economic welfare. Following the democratic election of a bargaining team and the member-ratification of a collective bargaining agreement, I hereby request and authorize my employer to deduct from each pay period of my earnings the required amount of Union dues, fees or other assessment adjusted periodically as established by the membership of AFSCME, AFL-CIO. I further authorize my employer to remit such amount monthly to AFSCME Council 18, 1202 Pennsylvania Street NE, Abq., NM 87110, as payment of my Union dues. This authorization shall remain in effect for one year, irrespective of whether I am a union member, and be automatically renewed for periods of one year from the date signed below, or until the expiration of the collective bargaining agreement, whichever is sooner. I can revoke this authorization by sending written notice to my employer and to the union not more than 20 days and not less than 10 days before the expiration of the yearly period, or before the expiration of the collective bargaining agreement, whichever is sooner.

Signature

My electronic signature is a binding and valid signature. By signing here I agree to all of the terms and conditions set out in this authorization, which apply to my membership and dues payments.

Date

PEOPLE

This section is completely voluntary. You do not have to sign up for a PEOPLE contribution. It is not the same as signing up for union membership.

PEOPLE Authorization

I hereby authorize my employer and associated agencies to deduct each pay period the amount certified as a voluntary contribution to be paid to the treasurer of American Federation of State, County, and Municipal Employees PEOPLE, AFSCME, AFL-CIO, P.O. Box 65334, Washington D.C. 20035-5334, to be used for the purpose of making political contributions and expenditures. My contribution is voluntary, and I understand that it is not required as a condition of membership in any organization, or as a condition of continued employment, and is free of reprisal. I understand that any contribution guideline is only a suggestion and I am free to contribute more or less than that amount and will not be favored or disadvantaged due to the amount of my contribution or refusal to contribute, and that I may revoke this authorization at any time by giving written notice.

Deduction per pay period

$9.62 MVP

$4.20 MVP

Other amount

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Would you like a PEOPLE jacket? (available with minimum $4.20 per pay period contribution)

Yes

Signature for PEOPLE Contribution only

In accordance with federal law, AFSCME PEOPLE will accept contributions only from members of AFSCME and their families. Contributions or gifts to AFSCME PEOPLE are not deductible as charitable contributions for federal tax purposes.

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AFSCME Council 18 - New Mexico
1202 Pennsylvania Street NE
Albuquerque, NM 87110

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