NEW MEMBER

2019-20 APPLICATION FOR ACTIVE MEMBERSHIP
EDUCATION MINNESOTA

An affiliate of the American Federation of Teachers, the National Education Association and AFL-CIO.

 

Please note that items marked with an asterisk (*) indicate a required field.

To print this form, click the print button to the right before hitting submit.











()-

* Phone type:





Gender:




* Preferred email type:



Secondary email type:












(UTC - 06:00)

Dues payments and contributions are not deductible as charitable contributions for federal income tax purposes. Ask your tax professional whether/how your dues payments might be otherwise reportable.

Political Action Committee (PAC): Your dues include $25 per year for the Education Minnesota PAC. The PAC uses these contributions to fund political action efforts to strengthen the collective voice of educators in public policy-making.

Foundation for Excellence in Teaching & Learning: Your dues include $5 per year towards the Education Minnesota Foundation. The foundation uses these contributions to fund member grants as well as workshops that support and promote access to learning and excellence in teaching.

Members desiring a refund from either the PAC or the foundation must mail, email or hand deliver a signed original refund request form specifying the member’s refund request within 30 days of submitting this membership application form. Members can request the form by calling 800-652-9073.

By providing my phone number, I understand and agree that Education Minnesota and its affiliates may use automated calling technologies and/or text message me on my cellular phone approximately 4-5 times per month. Education Minnesota and its affiliates will never charge for text message alerts. Carrier message and data rates may apply to such alerts. Text STOP to 877877 to stop receiving messages.

I agree to submit dues to my local, Education Minnesota, NEA, and AFT, and hereby request and voluntarily authorize my employer to deduct from my wages an amount equal to the regularly deducted dues uniformly applicable to members of my local, Education Minnesota, NEA, and AFT, and further that such amount deducted be sent to my local union for and on my behalf. This authorization shall remain in effect and shall be automatically renewed from year to year, irrespective of my membership in the union, unless I revoke it by submitting written notice to the local union during the thirty-day period that begins on September 1 and ends on September 30. Such revocation will take effect on October 1 in the year in which I submit the revocation.

If any provision of this agreement is determined to be unlawful or invalid, the remaining provisions will remain in effect. I understand that this agreement is voluntary and not a condition of employment and that I have the legal right to refuse to sign this agreement without suffering any reprisal. By signing this form, I agree to the terms above.

Typing your full name and date, constitutes your legal signature, verifying that all information entered on this form is true and accurate to the best of your knowledge.



Now(UTC - 06:00)

I AGREE