You can fill out this one-page form and join the Part-time Faculty Association of Maine (PATFA). Just print out the form, fill it out, sign it, and mail it to PATFA, 311 Belfast Hall, UMA-Bangor, 85 Texas Ave., Bangor ME 04401-4340. The University of Maine System will then be able to deduct membership dues.
ENROLLMENT FORM [revised April 2024]
Maine Part-time Faculty Association Payroll Deduction Authorization
□ You are hereby authorized and requested to deduct from wages due me and payable periodically the amount certified by PATFA/AFT Local No. 4593, AFL-CIO, as Membership Dues. The current membership dues total $80 per semester: $20 each September, October, November, December and $20 each February, March, April and May.
OR
□ You are hereby authorized and requested to deduct from wages due me and payable periodically the amount certified by PATFA/AFT Local No. 4593, AFL-CIO, as my contribution to the PATFA Adjunct Education & Development Fund. Contributions total $80 per semester: $20 each September, October, November, December and $20 each February, March, April and May.
Voluntary Deduction for Political Action
□ You are further authorized and requested to deduct from wages the amount of 50 cents each September, October, November, December, February, March, April and May and forward that amount to the PATFA Political Action Committee. This authorization is signed freely and voluntarily and not out of any fear of reprisal and on the understanding that the PATFA Political Action Committee is engaged in joint fundraising efforts with the AFL-CIO and will use the money contributed to those efforts to make political contributions and expenditures in connection with federal, state and local elections. This voluntary authorization may be revoked at any time by notifying the PATFA Political Action Committee in writing. Contributions or gifts to the PATFA Political Action Committee are not deductible as charitable contributions for federal income tax purposes. Employees have the right not to contribute without reprisal and will not be favored or disadvantaged because they have exercised this right. Employees are welcome to contribute more or less than 50 cents monthly. That is merely a suggestion. Checking this box authorizes and directs the University of Maine System to transfer and pay the sum so deducted to the Treasurer of PATFA/AFT Local No. 4593, AFL-CIO.
In consideration of the above described services rendered by the University of Maine System, the undersigned hereby releases and discharges the University of Maine System, its members, officers, agents, and employees from any and all liability whatsoever arising as a result of the authorization herein given. The authorization may be revoked by notice in writing to the University of Maine System and PATFA in accordance with the applicable collective bargaining agreement between them. The responsibility of the University of Maine System to deduct and remit dues or fees shall automatically cease upon termination of my employment and payment of all earned unpaid wages.
NAME:________________________________EMPLOYEE IDN*:_______________________________
TITLE:_______________________CAMPUS/WORK LOCATION(S):_____________________________
HOME ADDRESS:_____________________________________________________________________
HOME PHONE:__________WORK PHONE:______________EMAIL:____________________________
SIGNATURE:_____________________________________DATE:______________________________
Return to: PATFA, 311 Belfast Hall, UMA-Bangor, 85 Texas Ave., Bangor ME 04401-4340
*Employee ID number is on your pay stub.
Dues or contributions are deducted in four monthly payments each semester: in September, October, November, December, February, March, April, and May. Dues or contributions paid to the Part-time Faculty Association may not be deductible for income tax purposes; however, under limited circumstances, they may qualify as a business expense.