Pennsylvania Joint Board Union Membership Card

"*" indicates required fields

X/Twitter

This field is for validation purposes and should be left unchanged.

First Name*

Middle Initial*

Last Name*

Email*

Home Address*

Home Address 2

City*

State*

Zip Code*

Date of Birth*

Gender Identity

Last 4 Digits of Social Security*

Work Location*

Job Title*

Date of Hire

Home Phone*

Cell Phone*

By providing my phone number and email address I understand that the PA Joint Board, Workers United, SEIU and affiliates may use automated calling technologies, emails, and/or text messages on a cellular device to contact me on a periodic basis. The PA Joint Board will never charge me for text message alerts. Carrier messages and data rates may apply to such alerts. Text STOP to 787753 to stop receiving messages. Text HELP to 787753 for more information.

Membership Agreement

I hereby request and accept membership in the Pennsylvania Joint Board, Workers United, SEIU. I agree to abide by and be bound by the constitution and bylaws of the Pennsylvania Joint Board and I authorize the Pennsylvania Joint Board to act exclusively as my agent for the purpose of collective bargaining.

I hereby authorize and direct my employer, its successor, or any employer for which I work to deduct from my wages membership dues (which include periodic fixed dues, initiation fees, and assessments) which I am obligated to pay to the Union or its designee pursuant to the provisions of any current or future collective bargaining agreement.

Contributions or gifts to the Pennsylvania Joint Board are not tax deductible as charitable contributions for Federal income tax purposes. This authorization shall remain in effect and shall be irrevocable unless I revoke it by sending written notice via U.S. mail to both the employer and the Pennsylvania Joint Board during the period not less than thirty (30) days and not more than forty-five (45) days before the annual anniversary date of this agreement or the date of termination of the applicable contract between the employer and the Pennsylvania Joint Board, whichever occurs sooner. This authorization shall be automatically renewed as am irrevocable check-off from year to year unless I revoke it in writing during the window period, even if I have resigned my membership in the Pennsylvania Joint Board.

Your Full Name*