I, (signature)_________________________________________ (date)_______________
authorize the regular deduction from my salary of national, state, and local AAUP dues in the amounts shown below by the Auburn University Chapter of the American Association of University Professors. Such deduction will be in five (5) equal installments from January through May. This authorization will continue in force unless revoked by me in writing no sooner than fourteen (14) days preceding the anniversary date of this authorization.
Name _______________________________________________________________
Last First Middle
Preferred Mailing Address
_______________________________________________________
_______________________________________________________
City State Zip
Daytime Telephone Number ______________________________
Department_____________________________________________
Subject or discipline (if different from department)
_______________________________________________________
Rank: Full Professor_____ Associate_____ Assistant_____ Instructor______
Tenured? Yes ______ No______
Social Security Number _____-____-_____
Dues (Please check one):
_____ Full-Time, Tenured = $170 (National = $155 + State Conf. = $5 + Local Chapt. = $10)
_____ Entrant, Untentured years 1-4 = $ 93 (National = $78 + State Conf. = $5 + Local Chapt. = $10)
Please return form to:
Wayne Brewer
Entomology and Plant Pathology
301 Funchess Hall
334-844-2935
brewejw@auburn.edu