United to Raise Up Home Care!
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Yes, I'm ready to build a strong voice for home care workers!
I hereby apply for membership in the United Home Care Workers of Pennsylvania (UHWP), a joint partnership of SEIU Healthcare PA, 1199C/NUHHCE, and AFSCME Council 33, to represent me for purposes of collective bargaining between my employer and UWHP.
First Name *
Last Name *
E-Mail *
Street Address *
Zip Code *
Employer *
Your Signature *
Full name for signature
Date *
*By including your mobile number, you are authorizing United Home Care Workers of PA and its affiliated locals, using various automated technologies, to call you and get text alerts to you – on an occasional basis. We will never charge you for text messages, but carrier message & data rates may apply. Reply ‘STOP’ to unsubscribe, and ‘HELP’ for more info.
Membership Dues Deduction Authorization *
YES! I want to hold my elected leaders accountable.
Accountability Fund Contribution Amount
Signature *
Full name for signature
My signature above shows that I have reviewed and agree with the terms stated here.
This authorization is made voluntarily based on my specific understanding that: 1) I am not required to sign this form or make voluntary political contributions, part of which is remitted to SEIU COPE and part to AFSCME PEOPLE, as a condition of my employment or membership in UHWP; 2) I may refuse to contribute without reprisal; 3) Under law, only members who are U.S. Citizens or lawful permanent residents are eligible to contribute to SEIU COPE and AFSCME PEOPLE; 4) The contribution amounts on this form are merely suggestions, and I may contribute more or less by this or other means and that UHWP cannot favor or disadvantage me because of the amount of my contribution or my decision not to contribute; 5) SEIU COPE and AFSCME PEOPLE use the money they receive for political purposes – including, but not limited to, making contributions to and expenditures on behalf of candidates for federal, state, and local offices – and addressing political issues of public importance. This contribution is in addition to voluntary membership dues and existing contributions through payroll deduction and/or reoccurring automatic electronic funds transfer.

This authorization shall remain in effect until revoked by me in writing via U.S. mail to the UHWP. Contributions or gifts to SEIU COPE and AFSCME PEOPLE are not tax deductible as charitable contributions.
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