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Application for Membership CANADA (B.C.)

Form No. 107C (B.C.)

* Mandatory Fields

Name*
Address*
Date of Birth*
Date of Hire
Industry Where You Are Employed
How Did You Become An I.B.E.W.® Member?
Have You Ever Been A Member Of The I.B.E.W.®?

OBLIGATION OF I.B.E.W. ®

"I, the undersigned, in the presence of members of the International Brotherhood of Electrical Workers®, make application to join the I.B.E.W.®, and promise and agree to conform to and abide by the Constitution and laws of the I.B.E.W.® and its Local
Unions. 

I will further the purposes for which the I.B.E.W.® is instituted. I will bear allegiance to it and will not sacrifice its interest in any manner." I am applying for membership in Local         of the I.B.E.W.® (the "Union").

In applying for membership I understand that the Union intends to apply to be certified as my exclusive bargaining agent and to represent me in collective bargaining. I hereby give the Union my permission to disclose, retain, and use my personal information in accordance with its Privacy Policy.

Classification

Applicant Signature Section

Application Date*
Use your mouse or finger to draw your signature above

THIS PORTION TO BE FILLED OUT BY L.U. FINANCIAL SECRETARY

Initiation Date*
Type Of Membership*
PAID $2.00 Pension Adm. Fee?*
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