UAW 4811 Membership Card

Count Me In The Majority!
Name*

First NameLast Name
Cell Phone
UC Email*
example@uc.edu
Job Title*

ASE (TA, GSI, Tutor, Reader)SR (GSR, Trainee, Fellow)AR (Specialist, Project Scientist, Professional Researcher, CPP)Postdoc
Department Employed
Department Enrolled
Office/Lab Building
Room
PI/Supervisor
Campus*
I accept membership in the UAW and its designated Local that represents me with respect to my working conditions at UC. I agree to pay a one-time $10 initiation fee and monthly dues, currently 1.44% of my gross pay. I authorize UC to deduct the initiation fee and monthly membership dues from my pay and remit them to the Union. Unless revoked, this authorization is to remain in effect for all periods of time in which I am a UAW member and receiv- ing a paycheck for work performed in a UAW-represented unit.
Signature*

Clear
Date*

MonthDayYear
Date
I want to help make my Union stronger!

Contact me about getting involved.
Should be Empty:

Count Me In The Majority!