Movement of Rank and File Educators/ UFT

New Member Form

Todays Date ____/____/_____

Annual Dues $ 10

Name: __________________________________________________________________
I am a:
___UFT Member: Position (tchr, para, related service, secy,other?)____________________
School: ___________________________________________ District: ______________
School Level _______________________ Are you a Chapter Leader? Y/N Delegate ? Y/N
___Parent: What school does your child (children) attend?___________________________
___Community Member: Are you in any community organizations ?______________________
_______________________________________________________________________
___Students: What school do you attend?____________________________________________
Email (Non-DOE):

Phone: __(__________)___________________________________________________________________
Home Address (include city & zip):
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________

I am interested in the following committees: Media_____ Newsletter_____ Contract_____

High Stakes Testing ______Membership_____ Social/Fundraising______
Chapter Building ______
Which of the following skills/interests would you like to put to use for MORE:
___phone banking ___editing newsletter/leaflets ___graphic arts
___data entry
___writing
___fundraising
___ organizing at your school/community to increase awareness and MORE participation
Other:__________________________________________________________________
_______________________________________________________________________
Mail in with check made out to MORE Caucus:
MORE Caucus , 305 E. 140th St. #5A, New York, NY 1045
or you may join using PayPal on-line at: http://morecaucusnyc.org/
7/21/2013