Membership Application

I hereby authorize PSEA, during the month of January of each subsequent year, to arrange for deduction of an amount sufficient to cover my annual dues, as set by the Board of Trustees, from any money due me via PG&E as wages, and pay same to the Treasurer of Pacific Service Employees Association, as and for my annual dues in said Association. (Type your name and date below to accept).

I hereby authorize PSEA, during the month of December of each subsequent year, to arrange for deduction of an amount sufficient to cover my annual dues, as set by the Board of Trustees, from any money due me via PG&E as pension and pay same to the Treasurer of Pacific Service Employees Association, as and for my annual dues in said Association. (Type your name and date below to accept). If you are not eligible for pension deduction, you will be billed directly during the last quarter each year. (Type your name and date below to accept).