Madison/DC/MMSD Social share icons You must have JavaScript enabled to use this form. Leave this field blank First Name Last Name Street Address Apartment, Suite, etc. City State - Select -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Local - Select -Local 60 – Madison Area SchoolsLocal 65 – Dane County Employees – Highway & Transportation, Alliant Center, Airport, ZooLocal 705 – Badger Prairie Health Care CenterLocal 720 – Dane County Employees – Paraprof, Admin, ClericalLocal 895 – Dane County Health Care ProfessionalsLocal 1871 – Dane County ProfessionalsLocal 2634 – Dane County Social WorkersLocal 6000 – Madison City Name of Employer Occupation SSN (last four digits) Personal Email Work Email Home Phone Work Phone Cell Phone † † By providing my cell phone number I consent to receive calls (including recorded or autodialed calls, or texts) at that number from AFSCME and its affiliated labor, political and charitable organizations on any subject matter. My carrier’s rates may apply. I may modify my preferences by calling the Union at 608-826-1932 or emailing the Union at uniondues@afscme32.org. By providing my cell phone number I consent to receive calls (including recorded or autodialed calls, or texts) at that number from AFSCME and its affiliated labor, political and charitable organizations on any subject matter. My carrier’s rates may apply. PEOPLE: Fighting for Candidates Who Will Fight for UsAcross the country, Americans are facing an out-of-balance economy that favors the wealthy while wages remain stagnant for everyone else. Working families are struggling to get ahead and public services are under attack. AFSCME PEOPLE, our union’s political action fund, provides us with an opportunity to stand together to protect the benefits and rights we’ve won in our workplaces and our communities.We must take an active role to elect politicians who advocate for issues that are important to working families, like the need to balance the economy, defend workers’ rights, secure workers’ benefits, invest in public services, and ensure a secure retirement for all. By contributing today, you can help elect local, state and federal candidates who will fight for us and the issues we care about most. YES! I want to contribute to AFSCME PEOPLE. I authorize a monthly PEOPLE contribution (in addition to my monthly dues) through payroll deduction of: $8.35(MVP level) $10 $15 $20 Other… Enter contribution amount… Please check all that apply: New Contributor Increase If you would like a PEOPLE hoodie, please select your size: - None -4XL3XL2XLXLLMS (available with minimum $8.35 monthly contribution) Authorization I hereby apply for membership in AFSCME Council 32 and its successor or assign (hereafter the “Union”) and I agree to abide by its Constitution and Bylaws. I authorize the Union to act as my exclusive bargaining representative for purposes of collective bargaining with respect to wages, hours and other terms and conditions of employment with my Employer.Effective immediately, I hereby voluntarily authorize and direct my Employer to deduct from my pay each pay period, regardless of whether I am or remain a member of the Union, the amount of dues certified by the Union, and as they may be adjusted periodically by the Union, and to authorize my Employer to remit such amount monthly to the Union. This voluntary authorization and assignment shall be irrevocable, regardless of whether I am or remain a member of the Union, for a period of one year from the date of execution, and for year to year thereafter unless I give the Employer and the Union written notice of revocation at least 30 days before the end of any yearly period. This card supersedes any prior check-off authorization card I signed.I recognize that my authorization of dues deductions, and the continuation of such authorization from one year to the next, is voluntary and not a condition of my employment.Payments to the Union are not deductible as charitable donations for federal income tax purposes. However, state law may extend favored tax treatment. AFSCME uses voluntary contributions collected through its PEOPLE program, not dues, to contribute to candidates for federal office and in certain states where other funding is restricted. In accordance with federal law, AFSCME PEOPLE will accept contributions only from members of AFSCME and their families. Contributions or gifts to AFSCME PEOPLE are not deductible as charitable contributions for federal income tax purposes. My authorization of these withdrawals is given voluntarily and I understand that it is not required as a condition of membership in any organization, or as a condition of continued employment, and that I will suffer no reprisal if I choose not to authorize withdrawals for the benefit of AFSCME PEOPLE. I understand that AFSCME PEOPLE uses the money for political purposes. Signature Reset My electronic signature is a binding and valid signature. By signing here I agree to all of the terms and conditions set out in this authorization, which apply to my membership, dues payments and, if applicable, PEOPLE payments. YES! I want to commit to help my Local by giving a few hours a month to attend meetings and to advance the Local’s goals. Please have someone contact me to discuss my role in supporting my Local. Sign Your Card