Application for Membership

Application For Membership

INTERNATIONAL ASSOCIATION OF FIRE FIGHTERS - IAFF LOCAL 1159.
There are multiple pages to fill out and sign in this application packet. Please make sure you complete them all.
Today's Date
Name

First NameLast Name
Fire District / Department
Previous Local #:
Address

Street Address

Address Line 2

CityState

Zip
Email
example@example.com
Phone Number
Please enter a valid phone number.
Birthdate

MonthDayYear
Date
a. I acknowledge I am applying for membership with IAFF Local 1159 and agree to abide by its Constitution and By-Laws and the IAFF Constitution and By-Laws.

b. I Authorize IAFF Local 1159 to be my exclusive bargaining representative for wages, hours and other conditions of employment and no other labor organization is currently certified or recognized as the exclusive representative for any employee in the proposed bargaining unit.

c. I Authorize monthly payroll deductions for Union Dues in the amount of $116.84 or $58.42 bi-monthly.

d. As a Clackamas unit member, I authorize $4.00 per pay period toward Clackamas Shop Steward Fund.

e. As a Clackamas unit member, I authorize $1.50 per pay period toward Clackamas Firefighter Flower Fund.

Note: This document will be retained in IAFF Local 1159 files.
Signature:
Should be Empty:

Application For Membership