YES! I want to become a member of SEIU Healthcare Minnesota!

I hereby request and accept membership in SEIU Healthcare MN, and I authorize SEIU Healthcare MN to represent me for purposes of collective bargaining with the State of Minnesota. 

By providing my phone number, I understand that SEIU and its locals and affiliates may use automated calling technologies and/or text message me on my cellular phone on a periodic basis. SEIU will never charge for text message alerts. Carrier message and data rates may apply to such alerts. Text STOP to 787753 to stop receiving messages.

I hereby request and voluntarily authorize the State of Minnesota or their agent to deduct from my wages the correct amount of Union dues and other fees or assessments as shall be certified by SEIU Healthcare MN and to remit those amounts to SEIU Healthcare MN on my behalf. This authorization is irrevocable for a period of one year from the date of execution and from year to year thereafter, irrespective of my membership in the Union, unless I notify the Union in writing, with my valid signature, of my desire to revoke this authorization not less than thirty (30) and not more than forty-five (45) days before the annual anniversary date of this authorization.

While contributions or gifts to SEIU Healthcare Minnesota are not tax deductible as charitable contributions for Federal income tax purposes, they may be tax deductible under other provisions of the Internal Revenue Code.

The invalidity or unenforceability of any particular provision hereof shall not affect the other provisions, and this Agreement shall be construed in all respects as if such invalid or unenforceable provision were omitted. By submitting this form, it shows that I agree with the terms above.