Electronic Membership Form

HOW MUCH ARE

MONTHLY UNION DUES?

COMPLETE THE MEMBERSHIP APPLICATION FORM TODAY AND JOIN YOUR FELLOW NURSES IN MAKING A DIFFERENCE AT ROCKLEDGE REGIONAL MEDICAL CENTER.

MONTHLY DUES ARE BARELY OVER $30 PER MONTH. ROCKLEDGE REGIONAL MEDICAL CENTER WILL DEDUCT YOUR MONTHLY DUES BY DIVIDING THIS AMOUNT IN HALF, PAYING YOUR MONTHLY DUES FROM TWO PAYROLL CHECKS. UNION DUES ARE RETURNED MANY TIMES OVER THROUGH YOUR UNION CONTRACT. DUES COST BARELY A LITTLE OVER A $1.50 A DAY TO SECURE YOUR FUTURE.

DON'T FORGET TO CLICK ON THE "SUBMIT BUTTON" AND THEN YOUR MEMBERSHIP APPLICATION WILL BE IMMEDIATELY SUBMITTED. THANK YOU!

FOR FURTHER INFORMATION, CONTACT:

RRMCNURSES@gmail.com

Stephen Applegate, RN, President

(321) 258-4183

FNA Representative

(407) 487-2230

FAX: (407) 887-6092

Voluntary Authorization For Payroll Dues Deduction *

By entering my date of birth, I authorize my employer to deduct from my bi-weekly pay, beginning the first full pay period from the date this authorization is received by my employer, and to submit monthly dues/sums to the Florida Nurses Association. This authorization will continue until 1) revoked by me at any time with a 30 days written notice 2) the termination of my employment or 3) transfer, promotion or demotion out of this bargaining unit.

FNA, OPEIU Local 713 - Membership Form Enter your name below: *

RN License Number (if known)

ELECTRONIC FNA, OPEIU 713 MEMBERSHIP APPLICATION

Mailing Address: *

Date of Birth *

Cell Phone *

Home Email Address *

Working Shift Hours and Unit *

Referred by

Your Employer's Name: *

Date and time

Date of Authorization *

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Florida Nurses Association OPEIU Local 713