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JOIN PECG

 

To become a PECG member, you may view and fill out an application using Adobe Acrobat Reader. 

Click here for the printable application.

Get the free Acrobat Reader Here: 

 

If you do not have Acrobat Reader, you may also use the form below.  Just type right on your screen, print out, sign, and either fax or mail to:

PECG
660 J Street, Suite 445
Sacramento, CA 95814
(916) 446-0489 FAX


PECG MEMBERSHIP APPLICATION
Professional Engineers in California Government
(PLEASE PRINT OR TYPE)

 (Mr. Ms. or Mrs.?) 
 		 Name  (First  Middle Last)  
Home Address 
City   State Zip
SSN Department

E-Mail Address

City of Employment
 Office Telephone
Employment Designation:    Rank and File   Supervisory/Managerial
How did you hear about PECG Membership?
   Letter     Poster    Informer   Meeting  Other 
Recruiter - please name:

I hereby apply for membership in Professional Engineers in California Government (PECG) and designate PECG as my exclusive representative in all matters relating to wages, hours and other terms and conditions of employment for all other purposes provided by law.

I authorize the State Controller to deduct from my salary and transmit as designated an amount for membership dues and any benefit program for which I have applied which is sponsored by PECG. This authorization will remain in effect until cancelled by me or by PECG. I understand that termination of membership will cancel all deductions made under that authorization.

Signature ______________________________________ Date ___________________________

  Please check this box if you do not wish any portion of your dues to be contributed to PECG's Political Action Organization.  (Your dues will remain the same whether you check this or not.)