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I apply to begin or continue membership in United Administrators of San Francisco, Local 3 of the American Federation of School Administrators (AFSA), AFL-CIO (hereafter the “Union”) and agree to abide by its constitution, bylaws and rules. I authorize the Union and any successor to act as my exclusive bargaining representative for purposes of collective bargaining with respect to wages, hours and other terms and conditions of employment and other permissible subjects for bargaining pursuant to applicable law.

With this application, I hereby consent, authorize and direct my Employer to deduct from my salary and wages each pay period the amount of dues certified by the Union, and authorize my Employer to remit such amount to the Union. This authorization shall remain in force for one year and shall automatically renew each year on the anniversary date (one year from the date of signature below) unless I revoke by sending written notice to the Union at least 30 days prior to the anniversary date. I understand that this application and dues authorization is voluntary and not a condition of my employment.

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