District 1199C Hospital & Health Care Employees, Philadelphia & VicinityBenefit & Pension Funds of Hospital & Health Care Employees, Philadelphia & Vicinity

District 1199C Forms

To file a grievance or contribute to the Political Action Fund, you may need to submit a form. These forms are listed below. Simply click on the name of the form you want. Follow the instructions on the form, and send the completed form to the contact listed. Additional forms, such as, an Enrollment/Change form, or a Request for Pension Estimate form, are available in the Forms section of the Benefit and Pension Funds website. To go there now, click on this link.

AFSCME PEOPLE MVP Membership Form

AFSCME PEOPLE is for political action on an international level. Being in a Union means that there are a lot of “people” (corporations) who have a special interest in creating legislation that allows them to operate at a cheaper cost at the workers expense and sometimes safety. The PEOPLE Fund is to help us fight such political advancements and allows us to lobby for political policies that favor our members.

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Dues Check-Off Form

A “Dues Check-Off Form” enables the union to start removing dues from your pay check so that you can become a member in good standing.

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Political Action Fund Pledge Card

1199C’s PAC fund is for political action on a more local level. Being able to be a player in decideing who gets elected allows the Union to negotiate new contracts from a position of strength as well as pushing local legislation that benefits our members.

Yearly Pledge Card  |  Monthly Pledge Card


Grievance Report

This is a Grievance Report! Fill this out so that the Union can take the necessary steps to represent you!

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Grievance Form

This is a Grievance Report! Fill this out so that the Union can take the necessary steps to represent you!

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New Members Orientation Registration

Click the button below to complete your New Members Orientation Registration Form online.

Register Online