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Union Membership Application


First Name *
Last Name *
DOB *
Phone *
Email *
SSN *
Address *
City *
State *
Zip code *
Hire Date *
Job Classification *
Statement of Understanding

I understand that as a member of the Stanislaus County Deputy Sheriff’s Association (DSA) I will receive the following benefits: 1. Legal Defense Fund, 2. Long Term Disability Insurance, 3. PORAC Membership, 4. Life Insurance, 5. Retainer Fees to Goyette and Associates, and 6. Other Association Benefits.

If I decide to drop out of the DSA membership in the future I will make a written request to the President of the Association. If I decide to withdraw my membership, I have been advised of the following DSA policy:
  1. Employees within the bargaining unit who choose to drop out of the Association (hereinafter referred to as “non-members”) will receive no benefit or service of any kind, at any time, offered by the DSA;
  2. Non-members shall not have access to, nor may they join, any organization or service that is contingent upon membership in the DSA including PORAC and the PORAC Legal Defense Fund, and any insurance or other related benefit offered by or obtained through the DSA;
  3. Non-members shall not have access to the DSA’s legal counsel at any stage of any proceeding; and
  4. Should a non-member, making a written request to the DSA Board of Directors to rejoin the Association, he or she shall be allowed to do so but shall be required to pay back dues equivalent to four (4) years of regular dues to the DSA.

Nothing in this policy shall alter or change the legal duty of fair representation requirements that the law places upon the DSA and the Board of Directors.

Membership Dues:

I authorize the Auditor Controller Payroll to deduct the amount specified by the DSA from by biweekly salary and to adjust the amount of deduction to comply with dues and/or fees schedules determined by the said DSA. The current deduction amount for DSA Professional dues is $54.66
Employee Signature *

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Date *






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