Membership Application

I wish to join as member of MAPE and Team MAPE

Dues: $15 +$1 PAC contribution per pay period

I do not want to contribute $1/pay period to the Team MAPE-PAC. I only want to join MAPE for $15/pay period.

I wish to make an additional contribution to the Team MAPE Political Action Committee in the amount of:

First name: *

Last name: *

Home street: *

Home city: *

Home state: *

Home zip code: *

Home phone:

Home email:

Work phone:

Work email: *

Department/agency name: *

Recruited by:

Membership Application: I hereby make application to the Minnesota Association of Professional Employees. I understand that this membership shall continue and that I shall be obligated to pay dues and related assessments approved by the Association until such time as I terminate this membership by submitting my written resignation to MAPE. Such resignation is to become effective thirty (30) days following its receipt. Dues shall continue through the end of any payroll period which begins before the effective date of written resignation.

Payroll Deduction Authorization: I hereby authorize my employer to deduct the approved regular dues and related assessments of the Minnesota Association of Professional Employees, and submit such sums to the Association continuously unless and until this authorization is revoked by written notice to the employer and Association. Such notice shall not become effective until thirty (30) days after its receipt by the parties, and payroll deduction of such sums shall continue through the end of any payroll period beginning before the effective date of the notice. If for any reason my employment is terminated, payroll deduction of dues shall continue through any payroll period beginning before my final day of employment.

I understand and agree to the above terms

Membership Application

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