TEXAS STATE EMPLOYEES UNION CWA Local 6186

Membership Application

TSEU MEMBERSHIP APPLICATION

CONTACT INFORMATION

First Name

Last Name

EMPLOYMENT INFORMATION

MEMBERSHIP AUTHORIZATION AND DUES DETAILS

I authorize the monthly deduction from my salary or wages for membership dues to TSEU. I understand that I may revoke this authorization at any time by written notice.

check to authorize

Dues Amount (based on salary)

$17.00 - Salary below $20,000

$21.00 - Salary $20,000-$25,000

$25.00 - Salary $25,000-$30,000

$28.00 - Salary $30,000-$40,000

$30.00 - Salary $40,000-$50,000

$32.00 - Salary over $50,000

$13.00 - PART-TIME

$10.00 - RETIREE

Type of Account

Checking Account

Savings Account

POLITICAL ACTION FUND - PAF

Under federal law, no union dues can be used for political campaigns. Join our Political Action Fund by contributing $5 or more per month.

I authorize the monthly deduction from my checking account indicated below for my PAF membership. I understand that I may revoke this authorization at any time by written notice.

TSEU MEMBERSHIP APPLICATION

CONTACT INFORMATION

EMPLOYMENT INFORMATION

MEMBERSHIP AUTHORIZATION AND DUES DETAILS

I authorize the monthly deduction from my salary or wages for membership dues to TSEU. I understand that I may revoke this authorization at any time by written notice.

POLITICAL ACTION FUND - PAF

I authorize the monthly deduction from my checking account indicated below for my PAF membership. I understand that I may revoke this authorization at any time by written notice.

Please note: if you are unable to use a bank account draft for your dues, you can set up a monthly draft from a credit or debit card by filling out our Debit/Credit Card dues authorization.

Please be aware that if paying dues by bank draft or debit/credit card, it is the member’s responsibility to notify TSEU when they are no longer employed by the state.

You also have the option of joining as a Payroll Deduction from your paycheck or ERS annuity.

Current Agency or University employees:
Download a Payroll Deduction Membership Form– This form will allow for a monthly draft of your dues from your work paycheck. Completed applications will be processed and forwarded to your agency or university’s payroll office.

State Retirees:
Download an ERS Annuity deduction membership form – This form will allow for a monthly draft of your dues from your ERS annuity. Completed applications will be processed and forwarded to the Employees Retirement System of Texas.

TSEU MEMBERSHIP APPLICATION

CONTACT INFORMATION

EMPLOYMENT INFORMATION

MEMBERSHIP AUTHORIZATION AND DUES DETAILS

I authorize the monthly deduction from my salary or wages for membership dues to TSEU. I understand that I may revoke this authorization at any time by written notice.

POLITICAL ACTION FUND - PAF

I authorize the monthly deduction from my checking account indicated below for my PAF membership. I understand that I may revoke this authorization at any time by written notice.

Please note: if you are unable to use a bank account draft for your dues, you can set up a monthly draft from a credit or debit card by filling out our Debit/Credit Card dues authorization.

Please be aware that if paying dues by bank draft or debit/credit card, it is the member’s responsibility to notify TSEU when they are no longer employed by the state.

You also have the option of joining as a Payroll Deduction from your paycheck or ERS annuity.

Current Agency or University employees:Download a Payroll Deduction Membership Form– This form will allow for a monthly draft of your dues from your work paycheck. Completed applications will be processed and forwarded to your agency or university’s payroll office.

State Retirees:Download an ERS Annuity deduction membership form – This form will allow for a monthly draft of your dues from your ERS annuity. Completed applications will be processed and forwarded to the Employees Retirement System of Texas.

Current Agency or University employees:
Download a Payroll Deduction Membership Form– This form will allow for a monthly draft of your dues from your work paycheck. Completed applications will be processed and forwarded to your agency or university’s payroll office.

State Retirees:
Download an ERS Annuity deduction membership form – This form will allow for a monthly draft of your dues from your ERS annuity. Completed applications will be processed and forwarded to the Employees Retirement System of Texas.