Local 23 Member Registration

Local 23 Member Registration
EMPLOYER*
REPRESENTATION AUTHORIZATION

I hereby authorize UNITE HERE Local 23 ("the Union") to be my recognized or certified collective bargaining representative in all matters relating to my wages, hours and terms and conditions of employment at my current employer(s) and any future employers, and request and accept membership in the Union. I hereby agree to be bound by the Constitution of the UNITE HERE International Union and the bylaws of the Union.

DUES CHECKOFF

I hereby voluntarily request and authorize my employer to deduct from any wages or compensation due me, each and every month, the dues, initiation fees or reinstatement fees required as a condition of acquiring and maintaining membership in good standing in the Union, and I direct that the same be forwarded each month to the Union. This authorization shall remain in effect and shall be irrevocable unless I revoke it by sending written notice to both the Employer and the Union by registered mail during a period of ten (10) days either immediately after any anniversary of the date of this authorization or immediately after the date of termination of the applicable agreement between my Employer and the Union, whichever occurs sooner, and shall be automatically renewed as an irrevocable checkoff from year to year, unless revoked as hereinabove provided irrespective of whether I am or remain a member of the Union.
NAME*

First NameLast Name
ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
CELL PHONE*
Home Phone
Email
Enter your email address to receive a copy of your card.
JOB/POSITION*
Department/Outlet
Date of Hire

MonthDayYear
Date

Optional Demographics
Gender
Ethnicity
Preferred Language
Second Language

Collapse Stopper
Date of Birth

MonthDayYear
Date
Country of Origin/Home Country
Text Opt In

Opt In to receive important union communications via text messaging. Message and Data Rates May Apply. Expect approx. 3-4 msgs/month. To opt-out text STOP to 88789. Terms of use at http://help.mcommons.com/s/88789. For more information text HELP to 88789, or email local23@unitehere.org. For the Union’s privacy policy, see www.unitehere.org/privacy-policy.
SOCIAL SECURITY NUMBER (no hyphens)*
SIGNATURE*

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Today's Date*

MonthDayYear
Date

Local 23 Member Registration

TIP Campaign Authorization