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160 S. Hollywood Street • Memphis, TN 38112 • (901) 416-5300 • ww.

Union Dues Cancellation

Employee Name (Print): ________________________________

Social Security Number: ________________________________

I wish to cancel the following union dues:

AFSCME

M-SCEA

SEIU

TEA Dues / NEA Dues / UEA

Signature:_________________________________________ Date: ____________________

Please Note: Your request will be sent to the Payroll Office. Please allow up to two pay periods for the change to take effect.

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Shelby County Schools offers educational and employment opportunities without regard to race, color, religion, sex, creed, age, disability, national origin, or genetic information.

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