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ESP Membership Application Form

I hereby apply for membership in the Minneapolis Federation of Teachers, Local 59, ESP Chapter,
Education Minnesota, AFT, NEA, AFL-CIO and Minneapolis Regional Labor Federation.

Address:











Cope Checkoff Authorization

COPE Checkoff Authorization:

By choosing "yes" below, I hereby authorize the Minneapolis Board of Education to deduct from twenty (20) paychecks the sum indicated below and to forward that amount to Local 59, COPE, (Committee On Political Education). This authorization is signed freely and voluntarily with the understanding that MFT, Local 59, COPE is engaged in joint fund-raising with the AFT and AFL-CIO. The funds will be used to make political contributions and expenditures in connection with federal, state and local elections. This voluntary authorization may be revoked at any time by notifying in writing the Board of Education and the Minneapolis Federation of Teachers, Local 59, COPE. Contributions or donations to COPE are not deductible as charitable contribution for federal income tax purposes.



Dues, contributions, or gifts to the Minneapolis Federation of Teachers, Local 59 are not deductible as charitable contributions for Federal income tax purposes. Dues paid to the Minneapolis Federation of Teachers & ESPs, Local 59 may be deductible in limited circumstances subject to various restrictions imposed by the Internal Revenue Code, 2014.

Agreement:

I agree to submit dues to Education Minnesota and hereby request and voluntarily authorize my employer to deduct from my wages an amount equal to the regular monthly dues uniformly applicable to members of Education Minnesota or monthly service fee, and further that such amount so deducted be sent to such local union for and on my behalf. This authorization shall remain in effect and shall be automatically renewed from year to year, irrespective of my membership in the union, unless I revoke it by submitting written notice to both my employer and the local union during the seven-day period that begins on September 24 and ends on September 30. Such revocation will take effect on October 1 in the year in which I submit the revocation.

The invalidity or unenforceability of any particular provision hereof shall not affect the other provisions, and this Agreement shall be construed in all respects as if such invalid or unenforceable provision were omitted. By submitting this form, it shows that I agree with the terms above.

Dues payments and contributions are not deductible as charitable contributions for federal income tax purposes. Ask your tax professional whether/how your dues payments might be otherwise reportable. Political Action Committee (PAC): Your dues include $25 per year for the Education Minnesota PAC. The PAC uses these contributions to fund political action efforts to strengthen the collective voice of educators in public policy-making. Foundation for Excellence in Teaching & Learning: Your dues include $5 per year towards the Education Minnesota Foundation. The foundation uses these contributions to fund member grants as well as workshops that support and promote access to learning and excellence in teaching. Members desiring a refund from either the PAC or the foundation must mail, email or hand deliver a signed original refund request form specifying the member’s refund request within 30 days of submitting this membership application form. Members can request the form by calling 800-652-9073. By providing my phone number, I understand and agree that Education Minnesota and its affiliates may use automated calling technologies and/or text message me on my cellular phone approximately 4-5 times per month. Education Minnesota and its affiliates will never charge for text message alerts. Carrier message and data rates may apply to such alerts. Text STOP to 877877 to stop receiving messages. By providing my phone number, I understand and agree that Minneapolis Federation of Teachers & EPSs Local 59 may use automated calling technologies and/or text message me on my cellular phone approximately 4-5 times per month. Minneapolis Federation of Teachers & ESPs Local 59 will never charge for text message alerts. Carrier message and data rates may apply to such alerts. Text STOP to 612-460-7682 to stop receiving messages.

By checking the box below, I hereby agree with and understand the above text.

 

Typing your full name and date in the spaces below constitutes your legal signature, verifying that all information entered on this form is true and accurate to the best of your knowledge.

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