Membership Form Instructions
You will need to download the forms, fill them in and then sign them.
File to download: Membership Form and Disability Card 2017.pdf
You may send your signed and filled-in form as an attachment to an email
Membership Form Instructions (White Top Form)
The top of the white form most blanks are obvious. Here is help on a couple of tricky ones.
- Signature – there are two places for signature – be sure to sign both (top and bottom of form).
- Personal Email. This is important. This is the only way to reach you should CLC not allow us to use CLC email for some reason.
- School Building is “CLC”
The second part of the white form is a voluntary donation to the local PAC fund.
- Paragraph 1 – School District is College of Lake County District 532
- Paragraph 2 – “An additional twenty dollars . . .” Most adjuncts give $20 (it’s a one-time donation) and is automatically deducted only once a year, but you can put zero or any amount you want. This supports local elections for education-friendly candidates and school boards.
Accidental Death and Dismemberment Card (Pink Card)
The pink card is for Accidental Death and Dismemberment policy – the amount is not large (it was $25,000) but it comes free as a benefit for being a member of CLC-AFO.
- Email – You will need to scan the signed form and email it as an attachment to any of the people listed below.
- Intercampus Mail – You can send the form via intercampus mail to any officer listed below.
- Questions call Karen Florian: (847) 543-2000 ext 32601
Karen Florian President (EMPS) firstname.lastname@example.org
Lynette Thornburgh Secretary (BIO) LThornburg@clcillinois.edu
Jessica Hoth Treasurer (EMPS) JHoth@clcillinois.edu
Local 504 Membership
Betty McCann BMcCann@ift-aft.org