Page Title

Page Content

2020-2021 MEMBERSHIP APPLICATION

Your Local Association/ Utah Education Association/ National Education Association

Membership dues vary by local. Connect with your UniServ Director, Local President or Building Leader for a summary of membership.


This application is payroll deduction only. For additional methods of payment connect with your UniServ Office.

 

GENDER




RACE (optional)









**Race and Ethnicity  – Race information is optional and failure to provide it will in no way affect your membership status, rights or benefits in NEA, UEA or any of their affiliates. This information will be kept confidential.
 

ADDRESS (STREET, APT#)*

 
 
 
 
 
***Telephone Consumer Protection Act (TCPA) Consent – By providing my phone number, I understand that the National Education Association and its affiliates including the Utah Education Association, the local association, NEA Member Benefits and NEA360 may use automated calling techniques and/or text message me on my cellular phone on a periodic basis. The National Education Association, the Utah Education Association and the local association will never charge for text message alerts. Carrier message and data rates may apply to such alerts. Text STOP to 787753 to stop receiving messages. Text HELP to 787753 for more information.

EMPLOYMENT STATUS*



 

I AM




POSITION (major assignment)











 
YES to Membership Commitment – I want to join with my fellow employees and become a member of the local association, the Utah Education Association, and the National Education Association. I hereby request and voluntarily accept membership in these associations and agree to abide by the Constitution and Bylaws of all three associations. I hereby designate and empower the local association as my exclusive bargaining agent.
YES to annual Payment Authorization - I hereby agree to pay the annual dues, fees, and assessments established by the three associations in consideration for the services the union provides. I understand that those annual amounts, due on September 1 are subject to periodic change by the governing bodies of the associations but may not exceed three percent (3%) of my monthly salary. I authorize on a continuing basis, and regardless of my membership status, the payment of those annual amounts established by the three associations through payroll deduction or other arrangements unless I revoke this authorization in a signed writing sent to the local association for which the authorization is set to be cancelled.

The District is hereby authorized and directed to deduct the specific sum certified by UEA or its designee, and to pay the dues to UEA or its designee by payroll deduction. I may revoke this dues deduction authorization by submitting a written directive to the District.

MEMBERSHIP COMMITMENT*

 

PAYMENT AUTHORIZATION*

 

I UNDERSTAND THIS AGREEMENT IS VOLUNTARY AND IS NOT A CONDITION OF EMPLOYMENT AND THAT I HAVE THE LEGAL RIGHT TO REFUSE TO SIGN THIS AGREEMENT WITHOUT SUFFERING ANY REPRISAL.

 
 
 
I UNDERSTAND THAT CLICKING SUBMIT CONSTITUES A LEGAL DIGITAL SIGNATURE CONFIRMING MY UNDERSTANDING AND AGREEMENT TO ALL OF THE TERMS ABOVE, AND MY CONSENT TO ENGAGE IN THIS TRANSACTION BY ELECTRONIC MEANS.