C.O.P.E. Reg Form
Support the Union’s Committee on Political Education (COPE)
C.O.P.E Registration form
I hereby authorize the Cerritos Community College District to deduct from my
salary the sum of _____ ($10), ______($15), ________ ($25), or $ ___________ (any other amount) per pay period and forward that amount to Cerritos College Faculty Federation, Committee on Political Education (COPE).
Member: please print your name and sign and date as indicated below. Please return this form via inter-campus mail to either COPE Chair Dennis Falcon or Treasurer Mike Farina.
This authorization is signed freely and voluntarily and not out of any fear of reprisal and I will not be favored or disadvantaged because I exercise this right. I understand this money will be used by AFT/COPE to make political contributions. This voluntary authorization may be revoked at any time by notifying Cerritos College Faculty Federation, Committee on Political Education (COPE) Chair, Lyndsey Lefebvre at email@example.com or Treasurer, Terri Alenikov at firstname.lastname@example.org and submitting a written notice. Contributions or gifts to AFT/COPE are not deductible as charitable contributions for federal income tax purpose.