4Cs CT State Community College & Charter Oak PAC "*" indicates required fields PAC Signup Keep the Political Action Connection Working for Higher Education & Join Our Congress PAC! Every penny contributed to your 4Cs Political Action Committee supports a special interest group – 4Cs members! Decisions directly affecting our work lives and our CSCU system (including the community college and Charter Oak) are happening at the State Capitol. Our PAC allows our union to fight for properly funding our colleges and for funding public services for our communities and residents across our state. Your 4Cs PAC funds allows our support of our political goals. Member donations are the sole source of PAC funds – your money supports our students, our livelihoods and the communities our colleges educate. The grassroots political activism of the 4Cs has led to major victories. Use the form to support our Political Action Committee. Help bring about even greater wins in the years to come! Stronger Together!First Name*Last Name*Street Address*Zip Code*City*State/Province*Please select…AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificEmail* Home Phone*Mobile PhoneBy submitting your cell phone number you are agreeing to receive periodic text messages from this organization. Message and data rates may apply. Text HELP for more information. Text STOP to stop receiving messages.Worksite*Please select…AsnuntuckCapitalCollege OfficeGatewayHousatonicManchesterMiddlesexNaugatuck ValleyNorwalkNorthwesternQuinebaug ValleyThree RiversTunxisCharter Oak State CollegeSelect Your PAC Contribution Amount* $5 $10 $15 $20 $25 Other Other*State Contractor Checkbox* I attest that I am not, nor anyone in my direct family is, a state contractor. (State contractors and immediate family members are prohibited from donating). I hereby authorize 4Cs SEIU Local 1973 to file this payroll deduction form on my behalf with my employer to withhold the above amount per paycheck, and forward that amount to the 4Cs SEIU Local 1973 Political Action Committee, 907 Wethersfield Ave, Hartford, CT 06114. This authorization is made voluntarily based on my specific understanding that (1) the signing of this authorization form and the making of these voluntary contributions are not conditions of my employment or membership in any union; (2) I may refuse to contribute without any reprisal; (3) the amount of the monthly contribution is only a suggestion, and I may contribute more or less without fear of favor or disadvantage from 4Cs, SEIU Local 1973 or my employer; and (4) the 4Cs, SEIU Local 1973 PAC use the money it receives for political purposes, including but not limited to making contributions to and expenditures on behalf of candidates for federal, state, and local offices, including federal PACs, subject to applicable limits. And addressing political issues of public importance. I understand that contributions to the 4Cs, SEIU Local 1973 PAC are not deductible as charitable contributions for federal or state income tax purposes, and that state law requires 4Cs SEIU Local 1973 to use its best effort to collect and report the name, mailing address, occupation, and employer of individuals whose contributions exceed $200 in a calendar year. This authorization shall remain in full force and effect until revoked by me in writing to 4Cs SEIU Local 1973.Signature*EmailThis field is for validation purposes and should be left unchanged.
