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Membership Application Form

ARKANSAS LAW ENFORCEMENT UNION
I.U.P.A. LOCAL 880, AFL-CIO
Post Office Box 1432
Malvern, AR 72104-1432
Telephone (870) 535-2566 | Toll free (877) 880-2538 |
E-mail Us

Fill in this form, print it, sign it and fax it to (870) 535-3598
If we do not have payroll deduction at your department you must use the Bank Draft Authorization Agreement !
You do not have to fill out both.

I hereby become a member of the Arkansas Law Enforcement Union and authorize the Arkansas Law Enforcement Union to act as my representative for the purposes of collective bargaining with my employer, and to negotiate and conclude all agreements regarding wages, hours and conditions of employment. I understand that this statement of authorization may be used to obtain recognition from my employer without any election. Effective immediately, I hereby authorize my employer to deduct $10.23 from by earnings each pay period the amount sufficient to provide for the regular payment of the current rate of monthly dues ($22.16) established by the Arkansas Law Enforcement Union and any such changes in dues certified by the Treasurer of the Arkansas Law Enforcement Union. The amount deducted shall be paid to the Treasurer of the Arkansas Law Enforcement Union. These deductions shall be irrevocable for the period of one year from the date thereof and shall be automatically renewed and irrevocable for successive similar periods, unless revoked by written notice to the employer and the Treasurer of the Arkansas Law Enforcement Union, thirty (30) days prior to the anniversary of its signing.

Name

Address

City

State

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SSN

Home Phone

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Job Title

Agency

Facility

Signature

Date

ARKANSAS LAW ENFORCEMENT UNION USE ONLY

Date Filed

Key Issued*

Sponsor

*This key is property of ALEU IUPA Local 880, and must be returned upon request.