AFT-COPE WITHHOLDING
I hereby authorize the Anderson Community School Corporation to deduct the sum indicated below from each of my regular paychecks and to forward that amount to the Anderson Federation of Teachers' Committee on Political Education (AFT-COPE).
This authorization is voluntarily made on the specific understanding that the signing of this form and the making of payments to the AFT's Committee on Political Education are not conditions of membership in the AFT or employment with the Anderson Community School Corporation and that the AFT-COPE will use the money it receives to make political contributions and expenditures in connection with federal, state, and local elections.
It is understood this authorization shall remain in force until notification of withdrawal is made to the School Administration and the AFT-COPE.
NAME (print)
_________________________________________________DATE __________
SIGNATURE
_________________________________________________________________
HOME ADDRESS
_____________________________________________ZIP____________
HOME PHONE __________________________SCHOOL
BUILDING__________________
Indicate below the sum to be
withheld.
________$1.00
_______$2.00
________$3.00
________OTHER $_________
INCREASE CURRENT AMOUNT BY
$____________
Complete two (2) copies and return both of them to
your Building Representative or the AFT Office.
THIS REPLACES ALL OTHER COPIES AS OF SPRING 20001
All questions concerning this agreement shall be
referred to the AFT office (643-5432).