WORKERS UNITED

I Am Interested in Helping Make a Better Future

I want my rep to contact me as soon as possible, as I am interested in signing a WUPP (Workers United for Political Power) card.

I am interested in signing a WUPP card to get one of the following:

This authorization to be contacted is made voluntarily based on my specific understanding that:

1) I am not required to submit this form or make voluntary contributions to WUPP as a condition of my employment or membership in the union;

2) I may refuse to submit this form without reprisal;

3) Under law, only union members and executive / administrative staff who are U.S. Citizens or lawful permanent residents are eligible to contribute to WUPP;

4) The contribution amounts on this form are merely suggestions, and I may contribute more or less by this or other means without fear of favor or

disadvantage from Workers United or my employer;

5) WUPP uses the money it receives 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 authorization shall remain in effect until revoked by me in writing via U.S. mail to Workers United.

Contributions or gifts to WUPP are not tax deductible as charitable contributions.