Collective Bargaining Membership Application

2023 Dues Rates

Collective Bargaining Membership Application

Membership includes Ohio Nurses Association, AFT Nurses + Health Professionals, AFL-CIO, District Nurses Association and your Collective Bargaining Local Unit.

An equal opportunity and affirmative action organization | ONA dues are nonrefundable

Membership Application - Collective Bargaining 2023

Select your Employer*
- Akron General Medical Center
- Alliance Community Hospital
- Ashtabula County Medical Center
- City of Cleveland Division of Health
- Coshocton Regional Medical Center
- Cuyahoga County Health Department
- Defiance Regional Medical Center (Full Time Rates)
- East Liverpool Hospital
- Geneva Medical Center
- Hillside Rehabilitation Center
- Hoxworth Blood Center
- Lima Memorial Hospital
- Mary Rutan Hospital
- Mercy Allen Medical Center
- Ohio State University Hospitals
- OSU Transplant Nurses
- Salem Regional Medical Center
- St. Vincent Charity Medical Center
- Summit County Health Department
- Toledo-Lucas County Health Department
- Trinity East Medical Center
- Union Hospital
- University of Cincinnati Medical Center
- Visiting Nurses Association
Notice*
- Checking this box indicates that I have read the notice for my workplace.
Please review your the initial notices for your workplace here
Name*
First Middle Initial Last
Address*
Street Address City State ZIP Code
County*
Home Phone #*
Cell Phone #
Work Phone #
Work Fax #
Personal Email*
Enter Email Confirm Email
Work Email
Enter Email Confirm Email
US Citizen?*
- Yes
- No
Date of Birth*
Month
Day
Year
Last 4 Digits of SSN*
RN License Number
License State*
Basic School of Nursing*
Month and Year of Graduation from Basic Nursing Program*
Ohio Nurses Association Membership Assessments and Dues Rates

Collective bargaining membership assessments and dues include the National, State, District, AFT, AFL-CIO, and Local Unit fees.
One dollar ($1.00) per month of your dues goes to an account set up to support ONA’s political efforts. You may choose at anytime to opt out of this dues designation. Opting out does not reduce the dues amount. If you are interested in opting out, please contact the Director of Health Policy at (614) 969-3800.
ONA dues are not deductible as a charitable contribution for federal income tax, but can be partially deductible as a business expense. A percent of the dues not deductible is calculated each year based on the amount spent lobbying. When preparing your taxes, contact ONA for the percentage that is deductible in the year you make this payment.
ONA dues are nonrefundable.
The dollar amounts below represent the amount that will be deducted from your paycheck on a biweekly or monthly basis (depending on your workplace) or your checking account via ACH on a monthly basis.
Have you ever been a member of the Ohio Nurses Association before?*
- Yes
- No
Bargaining Unit Hire Date*
Month
Day
Year
Employee ID #
MEMBERSHIP AUTHORIZATION*
- YES, I want to join with my colleagues and become a member of the Ohio Nurses Association (ONA), AFT, AFL-CIO. I hereby request and voluntarily accept membership in ONA and I agree to abide by its Constitution and Bylaws. I authorize ONA to act as my exclusive representative in collective bargaining over wages, benefits, and other terms and conditions of employment with my employer.
I wish to have my dues collected through the following mechanism:*
- Payroll Deduction
- Electronic Dues Payment Plan (EDPP) - monthly EFT via ACH from your checking or savings account
Payment plan option can only be changed during December 1st thru December 31st. If you have questions please contact the Membership Department at support@ohnurses.org.
Akron General Medical Center - Full Rate* Quantity
Price: $37.36
*biweekly payroll deduction
Akron General Medical Center - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
Alliance Community Hospital - Full Rate*
Price:
*biweekly payroll deduction
Alliance Community Hospital - Full Rate*
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
Ashtabula County Medical Center - Full Rate
Price:
Payroll Deduction
Ashtabula County Medical Center - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
City of Cleveland Division of Health - Full Rate
Price:
Payroll Deduction
City of Cleveland Division of Health - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
Coshocton Regional Medical Center - Full Rate
Price:
Payroll Deduction
Coshocton Regional Medical Center - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
Cuyahoga County Health Department - Full Rate*
Price:
*biweekly payroll deduction
Cuyahoga County Health Department - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
Defiance Regional Medical Center Full Time - Full Rate
Price:
Biweekly Payroll Deduction
Defiance Regional Medical Center Full Time - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
East Liverpool City Hospital - Full Rate
Price:
Biweekly Payroll Deduction
East Liverpool City Hospital - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
Geneva Medical Center - Full Rate
Price:
Payroll Deduction
Geneva Medical Center - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
Hillside Rehabilitation Center - Full Rate
Price:
Payroll Deduction
Hillside Rehabilitation Center - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
Hoxworth Blood Center - Full Rate
Price:
Payroll Deduction
Hoxworth Blood Center - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
Lima Memorial Hospital - Full Rate
Price:
Biweekly Payroll Deduction (27 pay periods)
Lima Memorial Hospital - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
Mary Rutan Hospital - Full Rate
Price:
Payroll Deduction
Mary Rutan Hospital - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
Mercy Allen Medical Center - Full Rate
Price:
Payroll Deduction
Mercy Allen Medical Center - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
Ohio State University Hospitals - Full Rate
Price:
Payroll Deduction
Ohio State University Hospitals - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
OSU Transplant Nurses - Full Rate
Price:
Payroll Deduction
OSU Transplant Nurses - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
Salem Regional Medical Center - Full Rate
Price:
Payroll Deduction
Salem Regional Medical Center - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
St. Vincent Charity Medical Center - Full Rate
Price:
Biweekly Payroll Deduction
St. Vincent Charity Medical Center - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
Summit County Health Department - Full Rate
Price:
Biweekly Payroll Deduction
Summit County Health Department - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
Toledo Lucas County Health Department - Full Rate
Price:
Biweekly Payroll Deduction
Toledo Lucas County Health Department - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
Trinity East Medical Center - Full Rate
Price:
Payroll Deduction
Trinity East Medical Center - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
Union Hospital - Full Rate
Price:
Payroll Deduction
Union Hospital - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
University of Cincinnati Medical Center - Full Rate
Price:
Payroll Deduction
University of Cincinnati Medical Center - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
Product Name
Price: $43.85
Electronic Dues Payment Plan - Monthly EFT via ACH
Visiting Nurses Association - Full Rate
Price:
Payroll Deduction
Visiting Nurses Association - Full Rate
Price:
Electronic Dues Payment Plan - Monthly EFT via ACH
Dues Amount:
$0.00
Your monthly dues payment (or biweekly - denoted with *)
Payroll Deduction Authorization*
- I hereby request and voluntarily authorize my employer to deduct from my earnings and to pay over to ONA an amount equal to the regular monthly dues uniformly applicable to members of ONA. This authorization shall remain in effect and shall be irrevocable unless I revoke it by sending written notice via U.S. Mail to both the employer and ONA the period not less than thirty (30) days and not more than forty-five (45) days before the annual anniversary date of this agreement, or the date of termination of the applicable contract between the employer and ONA, whichever occurs sooner. This authorization shall be automatically renewed as an irrevocable check-off from year to year unless I revoke it in writing during the window period, even if I have resigned my membership in ONA.
Monthly payments are automatically deducted via ACH from your checking or savings account. AUTHORIZATION to provide monthly electronic payments to Ohio Nurses Association (ONA): This is to authorize ONA to withdraw monthly dues payments via ACH on or after the 15th day of each month from my checking or savings account. I understand this amount includes a monthly service fee of 33 cents. ONA is authorized to change the amount by giving the undersigned thirty (30) days notice. The undersigned may cancel this authorization upon receipt by ONA of written notification of termination twenty (20) days prior to the deduction date as designated above. ONA will charge a $15.00 fee for any returned drafts.
Name of Bank*
Bank Account Number*
Routing Number*
Account Type*
- Checking
- Savings
I authorize the Ohio Nurses Association to withdraw monthly dues payments via ACH on or after the 15th of each month from the account specified above.*

If you agree, type your full name in this field.
It is recommended on your behalf to print and keep this for your records.
Comments
This field is for validation purposes and should be left unchanged.

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Questions or need help?

Call us at 1-800-430-0056 or email support@ohnurses.org

Collective Bargaining Membership Application

Membership Application - Collective Bargaining 2023

Ohio Nurses Association Membership Assessments and Dues Rates

Questions or need help?