UK AAUP Membership Form

American Association of University Professors

Kentucky AAUP Conference

University of Kentucky AAUP Chapter

Please consider joining AAUP. To join, print out this web page (or call 7-6494 (606-257-6494) for copies of the forms). Mail the completed form to UK Chapter, AAUP, P.O. Box 730, University Station, CAMPUS. We will put you on the Kentucky Conference and UK Chapter rolls and forward the forms to AAUP.

You may remit dues through the bank debit plan (or, if your prefer, just write a check**). For membership in National AAUP, the Kentucky State Conference, and the UK Chapter, please complete the steps listed below. If you have questions about membership please telephone: 7-6494 (606-257-6494).

Check one of the following categories and circle the appropriate dues: (Rates valid through December 31, 1997)

Category	Ongoing Monthly*	Ongoing Single Payment**	New Member Monthly*	New Member Payment**
( ) Tenured	$10.00	$120.00	$5.42	$65.00
( ) Non-tenured	5.50	66.00	3.17	38.00
( ) Primarily administrative duties	7.84	94.00	3.50	42.00
( ) Part-time	3.17	38.00	2.00	24.00

Fill out the membership application found in the blue and orange "Academic Freedom is Not Free" brochure.

*If you want your dues paid through bank deduction fill out both the forms below. Attach either a voided check or a deposit ticket.

**If you want to pay in a single payment, make checks payable to AAUP.

Please Check One:

( ) New application. (May qualify for half dues for the first year)

( ) Application for reinstatement.

( ) Continuing membership changing over to bank debit.

Please do not use this form to renew your current membership.

Name: ________________________________________

(Please Print) Last, First, Middle

Preferred Mailing Address:

_________________________________________

Daytime Phone: (________) ___________________________

Fax Number: (________) _____________________________

e-mail address ______________________________________

Institution: _________________________________________

Academic Field and Rank _____________________________

Tenured: ( ) Yes ( ) No

Authorization Agreement for Direct Payments (ACH Debits)

AAUP Federal Tax ID # 53-0196-570

I (we) hereby authorize the American Association of University Professors (AAUP) to initiate debit entries to my (our) checking account indicated below at the financial institution named below to debit same such account.

Financial Institution Name ________________________________________________________

Branch _____________________________ Branch Phone Number _______________________

City ____________________________________ State _____________ ZIP _______________

Routing Number (obtain from Financial Institution) ____________________________________

Account Number ________________________ This is a ( ) checking ( ) savings account.

This authorization is to remain in full force and effect until AAUP has received written notification from me (or either of us) of its termination in such time and in such manner as to afford AAUP and my financial institution a reasonable opportunity to act on it.

Name(s) ___________________________________________ Date ________________

PLEASE PRINT

Signature ___________________________ Signature ____________________________