[Full Name]
[Home Address]
[City, State, Zipcode]
[Social security number (optional)]
[School district]
[Local association]
[Date]

Agency Fee Rebate
CTA Membership Accounting

P.O. Box 4178

Burlingame, California 94011-4178

Dear CTA:

Pursuant to the Settlement Agreement in Apple
v. CTA, Case No. 96 1904 K JFS (S.D. Cal. 1997), effective immediately,
I hereby resign my membership in your union at all levels.

As a nonmember of the NEA/CTA/local association, I object to, and request a rebate of, the amount of the NEA/CTA/local association agency fee spent for nonrepresentational activities and the portion of the $60 dues increase the CTA is using for politics. I expect to receive your rebate check within 30 days.

I also challenge the NEA’s, CTA’s and local association’s calculations of their chargeable amounts of the fees that are automatically deducted from my wages. I have no objection to the CTA providing my name and address to any other fee objector who seeks the identities of other fee objectors for purposes related to the upcoming arbitration case.

Sincerely,

[Signature]

[Your Name]

cc: 1. Local Association President;

     2. National Right to Work Legal Defense Foundation
         8001 Braddock Road
         Suite 600 (MLC)
         Springfield, Virginia 22160