SAN LUIS OBISPO COUNTY EMPLOYEES’ ASSOCIATION
MEMBERSHIP APPLICATION &
AUTHORIZATION OF PAYROLL DEDUCTION
Complete this form and return to SLOCEA at 1035 Walnut Street, San Luis Obispo, CA 93401.
Please contact SLOCEA with any questions or concerns at (805) 543-2021 or visit our website at www.slocea.org.
LAST NAME
FIRST NAME
MIDDLE
HOME ADDRESS (NUMBER, STREET, APT. NO.)
CITY
STATE
ZIP CODE
SOCIAL SECURITY #
CELL PHONE #
HIRE DATE
PRONOUNS
BIRTHDATE
DEPARTMENT
HOME E-MAIL ADDRESS
WORK LOCATION
The San Luis Obispo County Employees’ Association (SLOCEA) is the recognized exclusive representative for the
employee classifications that compose the following bargaining units:
• Unit # 1 County “Public Services Unit”
• Unit # 2 County “Trades, Crafts, and Services Unit”
• Unit # 5 County “Supervisory Unit”
• Unit # 13 County “Clerical Unit”
• Unit # 19 Superior Court “Supervisory Unit”
• LOCSD Los Osos Community Services District “Miscellaneous Unit”
As an employee represented in one of the above bargaining units, you qualify and are invited to apply for SLOCEA
membership, in accordance with SLOCEA Bylaws, Article I, Section 5. (See reverse for a partial list of membership
benefits).
I hereby apply for active membership in the San Luis Obispo County Employees’ Association and agree to
abide by all SLOCEA By-laws and Policies. I authorize appropriate deductions from my wages for payment of
dues and other programs that I may select.
(PLEASE CHECK ONE (1) BOX):
 I also voluntarily authorize, at the discretion of the SLOCEA Board of Directors, the use of a portion of
my dues for political action. (Political contributions are not tax deductible.)
 I choose not to have any portion of my dues allocated to SLOCEA’s Political Action Committee. I
understand that my dues will not increase or decrease because of this designation.
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EMPLOYEE/APPLICANT’S SIGNATURE
DATE
FOR SLOCEA USE ONLY
Org:
Job Class:
B.U.:
Hire Date:
Dues paid to the San Luis Obispo County Employees’ Association are not tax deductible
as charitable contributions. However, they may be tax deductible as ordinary and
necessary business expenses.