Public Sector Application

I hereby accept membership in District 1199J, National Union of Hospital and Health Care Employees, AFSCME, AFL-CIO, and designate said union to act for me as collective bargaining agent in all matters pertaining to conditions of employment. I hearby pledge to abide by the Constitution and By-Laws of District 1199J, National Union of Hospital and Health Care Employees, AFSCME, AFL-CIO.

I hereby apply for membership in District 1199J. National Union of Hospital and Health Care Employees AFSCME, AFL-CIO and designate that organization and its subordinate bodies as my representative onall matters affecting my wages, hours and other conditions of work. I hereby authorize my employer to make deductions every pay period in the amount certified by the Union as my current dues. The monthly amount deducted shall be paid to the National Union of Hospital and Health Care Employees, AFSCME AFL-CIO, no later than the tenth day of each month immediately following the date of deduction or following the date provided in the collective bargaining agreement for such deduction. The application serves to revoke any/all prior applications and/or authorizations heretofore signed by me.