MEMBERSHIP FORM - TEAMSTERS QUEBEC LOCAL 1999

I ask by the present to be admitted as a member of TEAMSTERS QUEBEC LOCAL 1999 (Affiliated to the International Brotherhood of Teamsters) with all the responsibility which it entails and I authorize it’s representatives to represent me in negotiating a collective agreement with my employer and that the employer provide to the union on inquiry any information necessary in regards to the union dues administration including my social security number as well as my employee’s file.

Is there another union currently in place that you are going to resign from? Yes No

The present resignation will come into effect at the time of notification to the above mentioned association. Moreover, the present constitutes a notice to my employer to cease perceiving my contribution in order to pay the above mentioned association but authorize my employer to perceive the same contribution to pay the following: TEAMSTERS QUEBEC LOCAL 1999 or to be held in trust until final settlement.

I resign from the union (name of the union in place) *

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Keep the same address for your online payment Yes

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MEMBERSHIP FORM - TEAMSTERS QUEBEC LOCAL 1999