Make your organization an affiliate of the Minnesota Retiree Council.
Download and complete this affiliation form and mail it to us at:
Minnesota Retiree Council
175 Aurora Avenue
St. Paul, MN 55103
The following organization hereby makes application for affiliation with the Minnesota State Retiree Council, AFL-CIO:
Your Organization name: _________________________________________________________
We are (check one):
___ The retiree organization of a local union.
___ A regional or statewide retiree organization of a single union.
___ A multi-union retiree organization of a regional or local labor federation. ___ A union that keeps retirees in its membership after retirement.
___ A union paying an affiliation fee for our retiree group or organization. ___ A union of active members only, affiliating to support the work of the Minnesota State Retiree Council.
Does your organization maintain a full-time staffed office?
(circle one) YES NO
Organization’s preferred mailing address
Name of contact person & position or title: ____________________________________________________________________
Phone: ____________________________________ Fax:___________________
Affiliated Membership Annual Fee
1–25 members $5.00
26–50 members $10.00
51–75 members $15.00
76–100 members $25.00
101–250 members $50.00
251–500 members $75.00
500+ members $100.00
Number of members in our organization: ________
Check enclosed in the amount of: $______
Please make check payable to: Minnesota State Retiree Council, AFL-CIO And please send check, along with this form, to Minnesota State Retiree Council, AFL-CIO 175 Aurora Avenue, Saint Paul, MN 55103 Request: If the name and contact information for your organization’s principal officer is different from the preferred mailing address given on this form, please write the principal officer’s information here:
Principal officer’s name & position: ____________________________________________________________________
Principal officer’s mailing address: _____________________________________________________________________________________________________________________________________________________________________________________
Principal officer’s phone: _________________________________
Principal officer’s email address:___________________________________
Please remember that, in order to have delegates and alternates at the Sept. 20, 2020 State Retiree Council Convention, organizations must be up-to-date with their affiliation fees.
Thank you for affiliating with the Minnesota State Retiree Council AFL-CIO! 175 Aurora Avenue, St. Paul, MN 55103
Phone: 651/227-7647 Ext. 121 Toll Free: 800/652-9004 Ext. 121