SEIU Healthcare MI Membership (Private) "*" indicates required fields First Name* Last Name* Street Address City Zip Code Email* Cell Phone* By providing my phone number, I understand the Service Employees International Union and affiliates may use automated calling technologies and/or text message me on my cellular phone on a periodic basis. SEIU will never charge for text message alerts. Carrier message and data rates may apply to such alerts. Text STOP to 787753 for more information. Review our Privacy Policy and Terms of Service. Help at 313-965-9450.Your Facility Name*Job Classification Yes, I want to join my fellow employees and become a member of SEIU Healthcare Michigan. I request and voluntarily accept membership in SEIU Healthcare Michigan and its successors or assigns (collectively “Healthcare Michigan”). This means I will receive the benefits and abide by the obligations of membership set forth in both Healthcare Michigan’s and the Service Employees International Union’s Constitutions and Bylaws. I authorize Healthcare Michigan to act as my representative in collective bargaining over wages, benefits, and other terms/conditions of employment with my employer, and as my exclusive representative where authorized by law. My membership will be continuous unless I resign by providing notice to Healthcare Michigan via U.S. mail (or other method if permitted by Healthcare Michigan’s policies). Signature*Today’s Date 10/16/2024Dues Deduction/Checkoff Authorization: I request and voluntarily authorize my employer to deduct from my earnings and to pay to Healthcare Michigan and its successors and assigns (collectively “Healthcare Michigan”) an amount equal to Healthcare Michigan’s regular dues. This dues deduction authorization shall remain in effect unless I revoke it by providing notice to Healthcare Michigan via U.S. mail (or other method if permitted by Healthcare Michigan’s policies) within 15 days before or after (1) the annual anniversary date of this agreement or (2) the termination of the applicable collective bargaining agreement between my employer and union (“my window periods”). This authorization will renew automatically from year to year even if I have resigned my membership, unless I revoke it during one of my window periods and as required by Healthcare Michigan’s policies. This authorization is voluntary and is not a condition of my employment, and I can decline to agree to it without reprisal. I understand that all members benefit from everyone’s commitments because they help build a strong union that is able to plan for the future. Contributions or gifts to SEIU Healthcare Michigan are not tax deductible as charity contributions.Signature*Today’s Date 10/16/2024NameThis field is for validation purposes and should be left unchanged.
