Union Membership Application – Alaska Nurses Association

Welcome to AaNA! Once you’re a union member, you’ll be able to begin using your benefits immediately.

If you have any question in filling out this form, please contact us.

Employer*

Unit/Department

Hire Date*

First Name*

Last Name*

Mailing Address*

City*

State*

Zip*

Cell Phone

Home Phone

Personal Email*

License Number

License State

Become a Member of our Union!*

Yes! I wish to become a full member of the Alaska Nurses Association, joining together with my colleagues to improve our lives at work, advocate for our profession, protect our patients, and lift up our community. I hereby accept membership in the Alaska Nurses Association and designate said union to act for me as collective bargaining agent in all matters pertaining to conditions of employment. I hereby pledge to abide by the Constitution and Bylaws of my bargaining unit and the Alaska Nurses Association. I hereby authorize my employer to deduct $12.71 per pay period ($330.46 per year) membership dues plus one percent of my gross salary per pay period (up to a maximum of $600 annually). I understand that full membership in AaNA will cost between $330.46 and $930.46 per year, depending upon my income from my employer.

Payroll Deduction Authorization*

I hereby authorize and direct my employer to deduct the above designation from my wages or salary, and to remit all such deductions so made to the Alaska Nurses Association. My employer is authorized to deduct dues according to the fee structure set by the Alaska Nurses Association. I understand that when I am on leave my union dues will not be deducted during the time period I am not working, and that when I resume working, back dues for the flat membership dues will be deducted for that time.

Get Involved
The key to a member-run organization is you. Get involved with one of our committees and bring your voice to AaNA!
Where are you interested in making a difference?

Legislative CommitteeProfessional Practice CommitteeEditorial CommitteeHealth and Safety Task forceI’m not sure yet. Please contact me to discuss.

Additional Message (optional)

Digital Signature Authorization*
By typing my name in the field below, I acknowledge that I am electronically signing this form to become a member of the Alaska Nurses Association and have the above authorized dues amounts deducted from my wages by my employer.