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I, the undersigned, hereby apply for membership in and designate the Fairfax County Government Employees Union (FCGEU) as my duly authorized representative on matters relating to my economic welfare, including retirement and health care. Please consider this your authority to abide by the Constitution and Bylaws of FCGEU.

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I hereby authorize my employer: Fairfax County Government to deduct from my earnings such amount of dues (currently $10 per pay period, but subject to change per a membership vote and in accordance with the Local's constitution and bylaws) as may now or hereinafter be payable by to the organization named above. This agreement shall remain in effect until such times as it is amended or rescinded by me in writing.