SEIU 521 Membership Application

Yes! I want to join with child care providers throughout California to make my voice heard by voting for Child Care Providers United in our union election.

Together, as a strong union with a seat at the table, providers have the power to raise rates, win benefits, improve training, expand access and affordability, and strengthen our communities.

I request and voluntarily authorize Child Care Providers United California (CCPU-CA), a joint partnership of SEIU and AFSCME, to act as my representative in collective bargaining with respect to my subsidy payments, and other terms and conditions of my work as a child care provider, and as my exclusive representative where authorized by law. I also request and voluntarily accept membership in CCPU-CA and SEIU Local 521 (“Local 521”). This means I will receive the benefits and abide by the obligations of membership set forth in the Constitutions and Bylaws of CCPU-CA, Local 521, and the Service Employees International Union (“SEIU”). I know that membership in CCPU-CA and Local 521 is voluntary and is not a condition of my work as a child care provider, and that I can decline to join without reprisal.

First Name*
Middle Name
Last Name*
Zip Code*
Home Phone
Cell Phone†
Work Phone
License #
Business Name

†By providing my phone number, I understand that CCPU-CA/SEIU 521, the Service Employees International Union (SEIU), its local unions, and affiliates may use automated calling technologies and/or text message me on my cellular phone on a periodic basis. CCPU-CA/SEIU will never charge for text message alerts. Carrier message and data rates may apply to such alerts. Text STOP to 787753 to stop receiving messages.