APPLICATION AND NOTICE
FOR MEMBERSHIP IN LOCAL UNION NO. 222 AFFILIATED WITH THE INTERNATIONAL BROTHERHOOD OF TEAMSTERS
Name
*
(FIRST NAME)
(MIDDLE INITIAL)
(LAST NAME)
Social Security No
*
Phone
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employer
*
Employer
*
Please Select
ABF
Albertsons
ALSCO
American Airlines
Bimbo Bakeries
Dean Dairy's
DHL
Forterra
Geneva Rock
Gold Cross Ambulance
Granite Construction
Hertz
Integrated Facility Services
Magna Water
MTC
MV Transportation
NCS-EML
Praxair
Rail Terminal Services
Ryder
Univar
UPS
UPS Cartage
UPS Freight
W.W. Clyde
YRC Freight
Hiring Hall
Seniority Date
*
/
Month
/
Day
Year
Date
Job Classification
*
Rate of Pay
*
Date Of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Email
*
example@example.com
Have you ever been a member of a Teamster Local Union?
*
If yes, what Local Union No.
DATE OF APPLICATION
*
/
Month
/
Day
Year
Date
Signature
*
Clear
My Beneficiary Is
*
Relationship
*
CHECKOFF AUTHORIZATION AND AGREEMENT
Name
*
First Name
Last Name
Signature
*
Clear
Social Security Number
*
Date
*
-
Month
-
Day
Year
Date
Address
*
Address
Street Address Line 2
City
State
Zip Code
Employer
*
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