COPE FORM

COPE CONTRIBUTION PAYROLL DEDUCTION

COPE is the Committee on Political Education. It is our union’s voluntary bi-partisan Political Action Committee used for political and legislative activities.

Our Union does not use our Union dues for political contributions or activities. COPE was established for this purpose.

We need to support pro-public-school issues, candidates and legislators, but we can't do it without you.

Just $1 per paycheck will make a huge difference if we all stand together.

Yes, I will contribute:

$1 per pay period

$5 per pay period

$10 per pay period

Other

Other Amount

I hereby authorize a per-pay period contribution to AFT Local 691 State and Local Committee on Political Education (AFT Local 691 COPE) in the amount indicated above. This authorization is signed freely and voluntarily and not out of any fear of reprisal, and I will not be vavored nor disadvantaged because I exercise this right. I understand that this money will be used to make political contributions by AFT Local 691 Cope. This voluntary authorization may be revoked at any time by notifying AFT Local 691 in writing of the desire to do so. Contributions or gifts to AFT Local 691 COPE are not deductible as charity contributions for income tax purposes. Contributions cannot be reimbursed or otherwise paid by any other person or entity. Candidates may include individuals runnor boards of education; city or county offices; the state legislature and other offices. I hereby authorize the Board of Education to deduct the above amount from my salary each pay period. PLEASE TYPE YOUR NAME BELOW TO SIGN.

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