Dear Friend:    The Illinois Association of Hispanic State Employees’ (IAHSE) membership committee would like to take this opportunity to invite you to become a member of IAHSE.   
It is IAHSE’s mission to increase and secure the number of Hispanic employees at all levels of State Government to ensure the full delivery of state services and resources to the Latino community.  A strong representation of Latinos is vital to promote change.  Your membership is very important to us! 
If you work for the State of Illinois, you can elect to pay by payroll deduction:  $5.00 would be deducted from each paycheck and you do not have to renew your membership every year or you may pay annually by check ($120.00).   If you are not a state employee you can still join IAHSE, as an Associate Member.  Please complete the information at the bottom portion of this letter and submit today at the membership table or mail back to us at the listed address.       Upon receipt of your membership dues, you will receive an IAHSE membership card. You will also receive AVISO newsletters, informational e-mails, and IAHSE event information.    Make a Difference, Join Today!

IAHSE Membership Committee  

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ILLINOIS ASSOCIATION OF HISPANIC STATE EMPLOYEES STATE OF ILLINOIS PAYROLL DEDUCTION AUTHORIZATION


DATE:______________________________             I AM PAID       [ ] Monthly         [ ] Semi-Monthly        [ ] Bi-weekly


 I hereby authorize a deduction in the amount certified as the current rate of dedution be withheld from my pay in accordance with the state Salary and Annuity Withholding Act. Deduction for Illinois Association Hispanic State employees payroll code No. 74

                                                                                                                                                                                                                   NAME _____________________________________________________________________________________________________                                                           Last                                                   First                                             Middle         


HOME ADDRESS___________________________________________________________________ CITY __________________________ ZIP ___________ 


AGENCY ____________________________PHONE (________) _______________________________ AGENCY PAYROLL CODE NO. _______________


BUSINESS ADDRESS____________________________________________________________CITY_________________ 


ZIP_________________________________ 


INITIAL DEDUCTION: Per Pay Period $ _________ Month $ _________ EFFECTIVE PAY PERIOD __________________ DATE _________________ 


SIGNED ___________________________________________________________________


PERSONAL E-MAIL______________________________________________________________________________

CHECK ONE:[ ] Full Membership (1 Year = $120.00 by check or cash)     [ ] Student Member (1 Year = $45)             
[ ] Payroll Deduction $10.00 a month  [ ] Associate Member (1 Year = $45)      [ ] Change of Address or Contact Information

IAHSE