SMART-TD Membership Application
Local 303 Springfield, MO
(Date)
*
/
Month
/
Day
Year
Date
Personal Details
Name
*
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
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California
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District of Columbia
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Maine
Maryland
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South Carolina
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Tennessee
Texas
Utah
Vermont
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Wisconsin
Wyoming
State
Zip Code
Primary Phone
*
Type of Phone
*
Cell
Home
Date of Birth
*
/
Month
/
Day
Year
Date
Email
*
example@example.com
SSN (last 4)
*
Membership Details
Local Number
*
Requested Membership Date
*
/
Month
/
Day
Year
Date
GCA
*
LCA
Employment Details
Home Terminal
*
Employer/Carrier
*
Employee ID/ Badge No.
*
Craft
*
Conductor
Engineer
Brakeman
Yardmaster
Other
U.S. Military Veteran Status
I am a veteran?
*
Yes
No
Branch
Dates: (Month/Year – Month/Year)
I hereby make application for membership in the SMART Transportation Division. I pledge my honor to faithfully observe the Constitution and laws of the SMART Transportation Division, including the bylaws of my local; to comply with the rules and regulations for the government of the SMART Transportation Division; not to make known to outsiders any private proceedings for the SMART Transportation Division; to faithfully perform all the duties assigned to me to the best of my ability and skill; to so conduct myself at all times as not to bring reproach upon my union and at all times bear true and faithful allegiance to the SMART Transportation Division.
Applicant Signature
*
I certify that I have witnessed the applicant’s signature hereto:
Do you have current members of SMART-TD Local 303 to sign your application? If not we will get them for you.
Please Select
Yes
No
In signing this application, we as members of the above number local, certify that to the best of our belief, the applicant is of good moral character and, if admitted to membership in the SMART Transportation Division, will be a worthy member.
Signature of Member #1
Signature of Member #2
Signature of Member #3
UNION DUES ARE NOT DEDUCTIBLE AS CHARITABLE CONTRIBUTIONS FOR FEDERAL INCOME TAX PURPOSES. DUES MAY QUALIFY AS BUSINESS EXPENSES, AND MAY BE DEDUCTIBLE IN LIMITED CIRCUMSTANCES SUBJECT TO VARIOUS RESTRICTIONS IMPOSED BY THE INTERNAL REVENUE CODE.
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