Associate Member Checkoff Authorization Form

The Associate Membership is a way for a surviving spouse, family member, or general supporter of the United Mine Workers to become part of the movement to restore fairness, justice, and dignity for working families.


Anyone can join the UMWA as an Associate member for just $5 a month!


Membership includes access to benefits and services reserved for union members that you can’t get anywhere else:



    Member Information

    (This information is required in order to sign you up as a UMWA Member, it will not be shared with any entity outside of the union.)

    Bank Account Information

    I, the undersigned, do hereby voluntarily authorize the United Mine Workers of America every month to debit my account for monies due to the United Mine Workers of America by me in the amount of $5 per month for Associate membership dues. This assignment, authorization, and directive shall be in full force and effect until I authorize the termination of said deductions. I agree and direct that this assignment, authorization, and direction shall be automatically renewed annually unless written notice is given by me no more than twenty (20) days or not less than ten (10) days prior to the renewal date.