Membership Application-Teamsters 996

Membership APPLICATION AND NOTICE
For Membership in Local Union No. Affiliated with the International Brotherhood of Teamsters
I voluntarily submit this Application for Membership in Local Union 996 Brotherhood of Teamsters, so that I may fully participate in the activities of the Union. I understand that by becom- ing and remaining a member of the Union, I will be entitled to attend membership meetings, participate in the devel- opment 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 exercising my right, as guaranteed by federal law, to join the Union and engage in collective activities with my fellow workers.
I understand that under the current law, I may elect "nonmember" status, and can satisfy any contractual obligation necessary to retain my employment by paying an amount equal to the uniform dues and initiation fee required of mem- bers of the Union. I also understand that if I elect not to become a member or remain a member, I may object to pay- ing the pro-rata portion of regular Union dues or fees that are not germane to collective bargaining, contract adminis- tration and grievance adjustment, and I can request the Local Union to provide me with information concerning its most recent allocation of expenditures devoted to activities that are both germane and non-germane to its performance as the collective bargaining representative sufficient to enable me to decide whether or not to become an objector. I understand that nonmembers who choose to object to paying the pro-rata portion of regular Union dues or fees that are not ger- mane to collective bargaining will be entitled to a reduction in fees based on the aforementioned allocation of expendi- tures, and will have the right to challenge the correctness of the allocation. The procedures for filing such challenges will be provided by my Local Union, upon request. I have read and understand the options available to me and submit this application to be admitted as a member of the Local Union.
Local Number
Local Number
Member Information
Name*

First NameMiddle InitialLast Name
Email*
example@example.com
Occupation
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone*
Format: (000) 000-0000.
Employer info
Employer*
Employment Date

MonthDayYear
Date
Employer Phone
Format: (000) 000-0000.
Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Initiation Fee $
Paid to
Date of Birth*

MonthDayYear
Date
Social Security No.*
Have you ever been a member of Teamsters Local Union?
If yes, what Local Union?
DATE OF APPLICATION*

MonthDayYear
Date
SIGNATURE OF APPLICANT*

Clear
Page 2 is CheckOff Authorization Information

Membership APPLICATION AND NOTICE

For Membership in Local Union No. Affiliated with the International Brotherhood of Teamsters

Member Information

Employer info

CHECKOFF AUTHORIZATION AND ASSIGNMENT