Loudoun: Membership & Dues Deduction

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Membership Authorization

I request and voluntarily accept membership in Loudoun County Government Employees Union/Service Employees International Union Virginia 512 and its successors or assigns (collectively, “SEIU VA 512”). This means I will receive the benefits and abide by the obligations of membership set forth in both SEIU VA 512's and the Service Employees International Union's Constitution and Bylaws. I authorize SEIU VA 512 to act as my representative in collective bargaining over wages, benefits, and other terms/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 to SEIU VA 512 via U.S. mail (or other method if permitted by SEIU VA 512's policies). I know that union membership is voluntary and not a condition of my employment, and that I can decline to join without reprisal.

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Dues Deduction Authorization

I request and voluntarily authorize my employer to deduct from my earnings and to pay to SEIU VA 512 an amount equal to SEIU VA 512's regular dues. This dues deduction authorization shall remain in effect unless I revoke it by providing notice to SEIU VA 512 via U.S. mail (or other method if permitted by SEIU VA 512's policies) within 15 days before or after (1) the annual anniversary date of this agreement or (2) the termination of the applicable collective bargaining agreement between my employer and union (“my window periods”). This authorization will renew automatically from year to year even if I have resigned my membership, unless I revoke it during one of my window periods and as required by SEIU VA 512's policies. 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 build a strong union that is able to plan for the future.

Contributions or gifts to SEIU VA 512 are not tax deductible as charitable contributions.

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