2017 RETIREE APPLICATION FOR ELECTION TO OFFICE WINTER 2017 LS/SEC/RETIREE/2017/01.13.17 MAILING 5 Please mail your application, with original signature, to: CSEA Statewide Election Committee, Attention: Legal Department, Box 7125, Capitol Station, Albany, New York 12224, by March 6, 2017. NO APPLICATION WILL BE CONSIDERED UNLESS THE QUALIFICATIONS LISTED BELOW ARE MET: Ø The candidate has been a member in good standing of his/her Retiree Local/Unit since June 1, 2016. Ø The candidate has not been a member of a competing retiree organization since June 1, 2016 (i.e., REPA). Ø The candidate is not currently serving a disciplinary penalty imposed by the CSEA Judicial Board. Ø The candidate is not currently the subject of a bonding claim by the Association or disqualified from being covered by the Association's surety bond. "Member in Good Standing" means that the candidate has fully paid dues continuously without interruption since June 1, 2016. If a candidate has any questions regarding membership status, please call CSEA’s Membership Department at 1-800-342-4146, ext. 1331. The Membership Department will verify a candidate’s eligibility to run for Retiree office. The office I am seeking is: Retiree Local -OR- Retiree Unit (check one) The name of the office I am seeking is: _________________________________________________________ (Name of Officer Position) PLEASE REFER TO THE ADDRESS LABEL ON THE BACK PAGE OF THIS NEWSLETTER FOR THE AVAILABLE POSITIONS IN YOUR LOCAL OR UNIT. Slate Name (if applicable): ________________________________________________________________ Candidate Name:________________________________________________________________________ Candidate CSEA ID Number:* _________________ *Call 1-800-342-4146, extension 1331 for your CSEA ID. Home Address: _________________________________________________________________________ Phone Numbers: (home:_________________________) (cell:____________________________) Email address: _________________________________________________________________________ I certify to the best of my knowledge that I meet the above-referenced election qualifications. _________________________________________________ ________________________ (Signature) (Date)
retiree_news_no_1_2017
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