PEOPLE Contributor Form

Work Email

Address Line 2
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Deduction per pay period $5 per pay period $10 per pay period $20 per pay period OTHER (enter amount below)
If you prefer to name a different amount than is listed above, please tell us what amount to deduct per pay period.
If you are already contributing and wish to increase your contributions, please enter the new total amount to deduct per pay period.
Jacket Size (PEOPLE Jacket) *
I hereby authorize my employer and associated agencies to deduct, each pay period, the amount selected above to be paid to the treasurer of American Federation of State, County, and Municipal Employees PEOPLE. AFSCME, AFL-CIO, POB Box 65334, Washington DC 20035-5334, to be used for the purpose of making political contributions and expenditures. My contribution is voluntary, and I understand that it is not required as a condition of my membership or as a condition of continued employment, and is free of reprisal. I understand that any contribution guideline is only a suggestion and I am free to contribute more or less than that amount and will not be favored or disadvantaged due to the amount of my contribution or refusal to contribute, and that I may revoke this authorization at any time giving written notice. *
I agree * By checking this box , I agree that my typed name above is the electronic representation of my signature and is legally binding - just the same as a pen-and-paper signature
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AFSCME PEOPLE Card

This is an official Payroll Deduction Authorization form for AFSCME PEOPLE (PAC) voluntary contributions. Your AFSCME Council 28 (WFSE) membership will be confirmed before this request is processed.

In accordance with federal law, AFSCME PEOPLE will accept contributions only from members of AFSCME and their immediate families. Contributions or gifts to AFSCME PEOPLE are not deductible as charitable contributions for federal income tax purposes.

Learn more about AFSCME PEOPLE at

PEOPLE Contributor Form

AFSCME PEOPLE Card

WFSE.org

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