Application Fillable

Application and Notice

For Membership in Local Union No 997
NEW MEMBERS PLEASE COMPLETE THE FORM IN ITS ENTIRETY

CURRENT MEMBERS MAY ONLY SUBMIT DRIVE APPLICATION

Affiliated with the International Brotherhood of Teamsters
I, the undersigned, hereby apply for admission to membership in the Teamsters Local Union 997 and voluntarily choose and designate it as my representative for purposes of collective bargaining, hereby revoking any contrary designation. If admitted to membership, I agree to abide by the Constitution of the International as well as the Local Union By-laws which are not in conflict with International laws.

I voluntarily submit this Application for Membership in Local Union 997, affiliated with the International Brotherhood of Teamsters, so that I may fully participate in the activites of the Union. I understand that by becoming and remaining a member of the Union, I will be entitled to attend membership meetings, participate in the development of contract proposals for collective bargaining, vote to ratify or reject collective bargaining agreements, run for Union office or support candidates of my choice, receive Union publications and take advantage of programs available only to Union members. I understand that only as a member of the Union will I be able to determine the course the Union takes to represent me in negotiations to improve my wages, fringe benefits and working conditions. And, I understand that the Union's strength and ability to represent my interests depends upon my excercising my right, as guaranteed by federal law, to join the Union and engage in collective activities with my fellow workers.
I have read and understand the options available to me and submit this application to be admitted as a member of the Local Union.
NAME

First Name Last Name
SSN (Last 4)
XXX-XX-1234
OCCUPATION
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Tshirt Size
EMPLOYER
EMAIL
example@example.com
DATE OF BIRTH

Month Day Year
Date
EMPLOYMENT DATE

Month Day Year
Date
CELL PHONE

Area Code Phone Number
HOME PHONE

Area Code Phone Number
INITIATION FEE $
PAID TO
GENDER
Male/Female
BENEFICIARY AND RELATIONSHIP
HAVE YOU EVER BEEN A MEMBER OF A TEAMSTER LOCAL UNION?

Yes No
IF YES, WHAT LOCAL UNION NO.
TODAY'S DATE

Month Day Year
Date
SIGNATURE

Clear

CHECK OFF AUTHORIZATION AND ASSIGNMENT

I, ______________________ hereby authorize my employer to deduct from my wages each and every month an amount equal to the monthly dues, initiation fees and uniform assessments of Local Union 997, and direct such amounts so deducted to be turned over each month lo the Secretary-Treasurer ol such Local Union for and on my behalf.

This authorization is voluntary and is not conditioned on my present or future membership in the Union.

This authorization and assignment shall be irrevocable for the term of the applicable contract between the union and the employer or for one year, whichever is the lesser, and shall automatically renew itself for successive yearly or applicable contract periods thereafter, whichever is lesser, unless I give written notice lo the company and the union at least sixty (60 days), but not more than seventy-five (75) days before any periodic renewal date of this authorization and assignment of my desire to revoke same.

I authorize Local Union 997 to enforce and transfer this Authorization to any Employer that it has under contract, including my present Employer, should I terminate my employment and be re-employed in the future. I further agree that, due to my negligence, should I not comply with the terms of this authorization and assignment, I will accept liability for any and all initiation fees, dues and assessments retroactive for any negligent period.
NAME

First Name Last Name
SSN (Last 4)
XXX-XX-1234
TODAY'S DATE

Month Day Year
Date
EMPLOYER
SIGNATURE

Clear
Union dues are not deductible as charitable contributions for
Federal Income Tax purposes.

DRIVE Application

Democrat Republican Independent Voter Education

What is DRIVE?

DRIVE History
I subscribe freely and voluntarily the sum indicated below each week to DRIVE with the understanding that this voluntary contribution may be used by DRIVE for political purposes, including contributions to support candidates for local, state, and federal offices. I understand my right to refuse to contribute without reprisal and that the amounts below serve merely as suggestions. I am free to subscibe more, less, or nothing without benefit or disadvantage.

I further hereby authorize and request my employer to deduct from my erarnings the sum indicated below each week to be remitted to National DRIVE.

I reserve the right in accordance with the applicable state or federal laws to revoke this voluntary authoriztion at any time by giving written notice to National DRIVE in accordance with such laws or otherwise

A copy of the DRIVE report is filed with the Federal Election Commision and is available for purchase from the Federal Election Commission, Washington, DC 20463. Donation not US tax deductible.
SUGGESTED WEEKLY VOLUNTARY CONTRIBUTION

$1.00 $2.00 $3.00 $5.00
EMPLOYER
NAME

First Name Last Name
SSN (Last 4)
XXX-XX-1234
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
TODAY'S DATE

Month Day Year
Date
SIGNATURE

Clear
Should be Empty:

Application and Notice