ALLIANCE OF CONCERNED TEACHERS UNION FORM

ALLIANCE OF CONCERNED TEACHERS
NATIONAL CAPITAL REGION UNION
Telefax 8285-9948/Mobile No.0995-879-8576 / actncrunion2017@gmail.com
APPLICATION FOR MEMBERSHIP
I hereby apply for membership with the Alliance of Concerned Teachers-National Capital Region. I will abide by the Union's Constitution and By-Laws and actively exercise my duties and responsibilities as a member.
Name

First NameLast Name
MI
Address*
School
Grade/Year/ Subject/s taught*
Birthday*
Tin No.*
APPROVED BY:
Email Address*
Reflector
Ms. RUBY ANA BERNARDO President
UNION DUES/MONTH
The monthly dues of members of the Alliance of Concerned Teachers-NCR as stated in Article of the Constitution and

By-Laws of the UNION approved in its Founding Assembly on November 11, 2011 amounts to twenty pesos (P20.00

I am authorizing the check off of twenty pesos (P20.00) from my basic salary as my monthly union dues.
Name and Signature

Clear
GSIS/SSS No:
Contact No:*
Date Accomplished*
Station No:*
Division:*
Employee No:*
Sex*
Age*
Teaching Designation*
Years of Service*
Civil Status*
Blood type*
Should be Empty:

ALLIANCE OF CONCERNED TEACHERS