Yes, I want to join with my fellow employees and become a member of SEIU Local 1. I request and voluntarily accept membership in SEIU Local 1 and its successors or assigns (collectively “Local 1”). This means I will receive the benefits and abide by the obligations of membership set forth in the Constitution and Bylaws of both Local 1 and the Service Employees International Union (“SEIU”). I authorize Local 1 to act as my representative in collective bargaining over wages, benefits, and other terms and 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 in writing to Local 1. I know that membership in the union is voluntary and is not a condition of my employment, and that I can decline to join without reprisal.

Dues Deduction/Initiation Fees/Checkoff Authorization: I request and voluntarily authorize my employer to deduct from my earnings and to pay to Local 1 and its successors and assigns (collectively “Local 1”) an amount equal to the regular monthly dues and initiation fees uniformly applicable to members of Local 1. Local 1 is authorized to deposit this authorization with my current Employer(s) and with any other Employer(s) under contract with Local 1 in the event I change Employers or obtain additional employment. This authorization will remain effective if my employment with the Employer is terminated and I am later re-employed by the Employer. This authorization shall remain in effect unless I revoke it by sending written notice to Local 1 during the periods not less than thirty (30) days and not more than forty-five (45) days before either (1) the annual anniversary date of this agreement, or (2) the date of termination of the applicable collective bargaining agreement between the employer and Local 1. This authorization shall be automatically renewed from year to year unless I revoke it in writing during a window period, even if I have resigned my membership. 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 to build a strong union that is able to plan for the future.

Contribution or gifts to Local 1 are not tax deductible as charitable contributions.