ACMEA Dues Authorization

Have you completed your probationary period at your job?

THANKS FOR YOUR INTEREST, BUT WE WANT YOU TO FOCUS YOUR TIME ON PASSING YOUR PROBATIONARY PERIOD FIRST BEFORE VOLUNTEERING TO BE A SHOP STEWARD. WE WELCOME YOU TO APPLY AGAIN ONCE YOU PASS YOUR PROBATIONARY PERIOD!

Are you currently facing a disciplinary matter at work?

THANKS FOR YOUR INTEREST, BUT WE WANT YOU TO FOCUS YOUR TIME ON YOUR DISCIPLINARY MATTER FIRST BEFORE VOLUNTEERING TO BE A SHOP STEWARD. WE WELCOME YOU TO APPLY AGAIN ONCE YOUR MATTER HAS BEEN RESOLVED!

How long have you been a dues paying member?

In a few words, please tell us why you would like to become a Shop Steward?

Employee ID Number*

Your Job Title*

First Name*

Last Name*

Suffix

Personal Email Address:*

example@example.com

Work Email*

example@example.com

Personal Cell Number*

Area CodePhone Number

Your Bargaining Unit*

Your Employer*

Your Agency Name*

What is your job site address?

Street Address

Street Address Line 2

CityState

Zip Code

Signature (use your PC mouse or finger to sign)

Date*

DateHourMinutesAM/PM Option