SETC-United Scholarship Application

MEMBERSHIP FORM
DUES AUTHORIZATION
BENEFICIARY/ADDRESS CHANGE/EMAIL CHANGE

I hereby request and accept membership in the State Employees Trades Council-United (SETC-United). I accept and assume all rights and obligations of membership in SETC-United, including the obligation to pay membership dues in an amount equivalent to the membership dues approved by the membership of the State Employees Trades Council-United.

I authorize my employer, the California State University (CSU) to deduct the monthly membership dues for SETC-United from my wages and remit these deductions directly to SETC-United. This authorization supersedes and revokes any and all prior authorizations for deduction of union dues from my wages earned as a CSU employee.

Any separation of employment will automatically terminate your membership dues. If you are rehired and wish to activate your membership, please submit another application, including your social security.

If you are signing up as a new member, please fill out this form in its entirety. If you are already a member, you do not need to provide your social security number.


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New Member Applicants are required to fill out ALL FIELDS.
* † ‡ signifies which fields need to be filled out for Information Changes

Employment Status:

  • Temporary Employee
  • Permanent Employee

Select Application Type:

  • Change in Beneficiary †
  • Email Address Change ‡

Personal Information


Beneficiary Information


Cancellation of your membership must be made in writing to the Main Office address at:

6366 Commerce Blvd. #346
Rohnert Park, CA 94928

Before clicking Submit, please print for your records

By clicking the Submit button, you agree to the terms set forth above.