"*" indicates required fields
Initiation Fee* $20.00
Have you ever been a member of any Teamster Local Union?*
NoYes
If yes, what Local Union No.
Date of Application*
Signature of Applicant*
I (enter full name here)* hereby authorize my employer to deduct from my wages each and every month an amount equal to the monthly dues, initiation fees and uniform assessments of Local Union 90, and direct such amounts so deducted to be turned over each month to the Secretary-Treasurer of such Local Union for and on my behalf.
This authorization is voluntary and is not conditioned on my present or future membership in the Union.
This authorization and assignment shall be irrevocable for the term of the applicable contract between the union and the employer or for one year, whichever is the lesser, and shall automatically renew itself for successive yearly or applicable contract periods thereafter, whichever is lesser, unless I give written notice to the company and the union at least sixty [60] days, but not more than seventy-five [75] days before any periodic renewal date of this authorization and assignment of my desire to revoke same.
*I have read and understand the options available to me and submit this application to be admitted as a member of the Local Union.
Date*
Signature of Applicant* Signature: Use your mouse, finger, or touch device to write your signature. Clear