Membership Application
To join the union, please print this application and send it to:

Oakland AFT
1 Kaiser Plaza, Suite 1440
Oakland, CA 94612

Name:_____________________________

Pay Location:_____________________________

Home Phone Number:_____________________________

Home Address:_____________________________

City:_____________________________ Zip:__________

Social Security #:_____________________________

ADULT EDUCATION HOURLY
__ 0-9 hours a week: $12/month ..... ($6.00/pay warrant)
__ 10-15 hours a week: $16/month ..... ($8.00/pay warrant)
__ 16+ hours a week: $20/month ..... ($10.00/pay warrant)

I hereby authorize the Oakland Unified School District or its agent
to withhold from each of my pay warrants $________ and to transmit
said sum to the Oakland AFT, CFT/AFT Local 771, AFL-CIO. I further
authorize the Treasurer of the Oakland AFT with power of attorney
in fact to prepare, sign, and execute payroll deductions to pay my
AFT dues. This authorization shall be in full force and effect
until revoked in writing by the undersigned or the Oakland AFT.
Effective date shall be in next pay period following the receipt of
the authorization by the OUSD.

Signature_________________________________________________