• SEIU Local 668 Membership Form (PLRB)

    You and your fellow members elect the leadership of Local 668, who determine the strategic plan of the union, set the policies and budget that governs all union activity. Through popular vote, we choose two statewide officers, three trustees, chapter chairs, committee chairs and shop stewards. The rules and regulations that govern our union are outlined in the SEIU 668 Constitution. All members vote to accept or reject their contracts, which include decisions on: wages; medical, dental and vision insurance; retirement; working conditions; vacation policies; health and safety in the workplace; and career/professional development.
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  • Do you wish to receive periodic text messages from SEIU Local 668? By checking "Yes," I understand that SEIU and its locals and affiliates may use automated calling technologies and/or text message me on my cellular phone on a periodic basis. SEIU will never charge for text message alerts. Carrier message and data rates may apply to such alerts. Text STOP to 787753 to stop receiving messages. Text HELP to 787753 for more information.*
  • Do you wish to receive emails from SEIU Local 668? Please note, we will only send emails to your personal email address, not your employer email address.*
  • Date of Birth*
  • Gender - Select one of the options below, or share a word that reflects your internal sense of gender: e.g. Non-binary

  • Do you work for the Commonwealth of Pennsylvania?*

  • Electronic Signature Agreement (I understand and accept that the electronic signatures appearing on this agreement are the same as handwritten signatures for the purposes of validity, enforceability and admissibility.) YES! I want to join my fellow employees and become a member of SEIU Local 668. I request and accept membership in SEIU Local 668 and I agree to abide by the SEIU Local 668 constitution and by-laws. I authorize SEIU Local 668 to act as my exclusive representative in collective bargaining over wages, benefits and other terms and conditions of employment with my employer. I understand that membership and dues deduction require separate authorizations. I also understand that dues deduction is a requirement for membership in SEIU Local 668 and that my financial obligations to SEIU Local 668 are governed by the provisions below.

  • Date Signed*

  • Voluntary Authorization: I request and voluntarily authorize my employer to deduct from my earnings and pay Local 668 an amount equal to local 668’s regular dues. This dues deduction authorization shall remain in effect, regardless ofwhether I remain a member of the Union, for a period of one year from the date of execution and will renewautomatically from year to year as long as my employment continues, unless I revoke it by providing notice toLocal 668 via U.S. mail within the 30-day period before the anniversary date of this agreement.I acknowledge that my dues deduction authorization is a contractual agreement between myself, as a bargaining unit employee, and SEIU Local 668, separate from any statutory provisions of Act 195. This authorization is not a condition of employment and I can decline to agree to it without reprisal. Dues, fees, and assessments to SEIU Local 668 are not deductible as charitable contributions for federal income tax purposes.

  • Date Signed*
  • Building—and maintaining—our political strength begins with you. COPE which stands for Committee on Political Education is a non-partisan Political Action Committee (501(c)(4)) fund made up of voluntary contributions from members like you. These funds are used to support pro-worker candidates on both sides of the aisle as well as political work that benefits you. Dues money cannot be used for partisan political purposes, but COPE lets us have a stronger voice in the political process. We ask members to make voluntary contributions to SEIU 668’s COPE PAC fund so that we can help elect candidates who stand up for issues important to working families. Would you like to contribute to COPE?*
  • I authorize my employer to deduct each pay period the amount certified below as voluntary contribution to be paid to the Secretary-Treasurer of the SEIU Local 668 COPE, 2589 Interstate Drive, Harrisburg, PA 17110-9602 for SEIU COPE to be used for political purposes, including but not limited to making contributions to and expenditures for candidates for federal, state, and local offices and addressing political issues of public importance.The contribution amounts on this form are merely a suggestion, and I may contribute more or less by this or some other means without fear of favor or disadvantage from the union or my employer. Only union members and executive/administrative union staff who are U.S. citizens or lawful permanent residents are eligible to contribute to SEIU COPE. My contribution is voluntary, and I understand that it is not required as a condition of membership in any organization, or as a condition of continued employment, and is free of reprisal, and that I may revoke this authorization at any time by giving written notice to SEIU Local 668 c/o JoAnne Sessa, Secretary-Treasurer, 2589 Interstate Drive, Harrisburg PA 17110. Contributions to SEIU COPE are not deductible as charitable contributions for federal income tax purposes.*

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