New Organizing Membership Card - MetroHealth Social share icons You must have JavaScript enabled to use this form. Current Your Info Authorization for Representation and Dues Complete Leave this field blank New Organizing Membership Card First Name Last Name Street Address Apartment, Suite, etc. City State - Select -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Personal Email Primary Phone Number Personal Cell Phone † † By providing my cell phone number I consent to receiving calls (including recorded or automated calls or texts) at the number from AFSCME and its affiliated labor, political and charitable organizations on any subject matter. My carrier’s rates may apply. I may notify my preferences by calling the union at (614) 841-1918 or emailing the union at authorizationcard@afscme8.org. By providing my cell phone number I consent to receive calls (including recorded or autodialed calls, or texts) at that number from AFSCME and its affiliated labor, political and charitable organizations on any subject matter. My carrier’s rates may apply. Last 4 Digits of Your Social Security Number Employer Local # Worksite/Building Job Title Next
