supalogoappSTATEWIDE UNIVERSITY POLICE ASSOCIATION
Application for Membership and Salary Deduction Authorization

* Note: If you do not receive a confirmation email, please check your spam folder.
Social Security Number*
Please provide your social security number.

Campus*
Please select a campus.

First Name*
Please provide your first name.

Last Name*
Please provide your last name.

Middle Initial

Street Address*
Please provide your street address.

City*
Please provide the city you live in.

State*
Please provide the State you live in.

Zip*
Please provide a valid zip code.

Cell Number*
Please provide a valid cell phone number.

Work Number

Date Of Hire*
Invalid Input

Email Address*
Please provide a valid email address.

Job Classification Code*
Please select your job classification code.

Date Of Birth*
/ / Please provide your Date Of Birth

I wish to be represented by SUPA as my sole and exclusive collective bargaining representative for all matters relating to wages, hours and other terms and conditions of employment.

I hereby apply for membership in the Statewide University Police Association (SUPA) and agree to abide by the Constitution and Bylaws and written policy of the Association at any level and authorize my employer to deduct from my salary and pay to SUPA the periodic dues or other deductions for services provided by or through SUPA. If an increase or decrease in dues or other deductions is adopted by SUPA, this authorization shall include the then-established dues or other deductions and no new authorization shall be required.

*NOTE:Your SUPA membership in good standing for purposes of establishing voting rights and eligibility to hold SUPA offices will not commence until the first of the month after the first payroll deduction has been taken, unless cash payment for the interim period is remitted with this application. Full dues paying SUPA Members receive labor relations representation, membership in PORAC and LDF coverage. Fair Share fee payers only receive labor relations representation.

Electronic Signature*
Invalid Electronic Signature

Captcha
Invalid Input

Join our mailing list!
supalogoappSubscribe to the SUPA mailing list, please fill out the information below and select "Sign up"
Join our mailing list!
supalogoappSubscribe to the SUPA mailing list, please fill out the information below and select "Sign up"