TEAMSTERS LOCAL 142

APPLICATION AND NOTICE
For Membership in Local Union No. 142
Affiliated with the International Brotherhood of Teamsters

I voluntarily submit this Application for Membership in Local Union 142, affiliated with the International Brotherhood of Teamsters, so that I may fully participate in the activities of the Union. I understand that by becoming and remaining a member of the Union, I will be entitled to attend membership meetings, participate in the development of contract proposals for collective bargaining, vote to ratify or reject collective bargaining agreements, run for Union office or support candidates of my choice, receive Union publications and take advantage of programs available only to Union members. I understand that only as a member of the Union will I be able to determine the course the Union takes to represent me in negotiations to improve my wages, fringe benefits and working conditions. And, I understand that the Union’s strength and ability to represent my interests depends upon my exercising my right, as guaranteed by federal law, to join the Union and engage in collective activities with my fellow workers.

I understand that under the current law, I may elect “nonmember” status, and can satisfy any contractual obligation necessary to retain my employment by paying an amount equal to the uniform dues and initiation fee required of members of the Union. I also understand that if I elect not to become a member or remain a member, I may object to paying the pro- rata portion of regular Union dues or fees that are not germane to collective bargaining contract administration and grievances adjustment, and I can request the Local Union to provide me with information concerning its most recent allocation of expenditures devoted to activities that are both germane and non-germane to its performance as the collective bargaining representative sufficient to enable me to become an objector. I understand that nonmembers who choose to object to paying the pro-rata portion of regular Union dues or fees that are not germane to collective bargaining will be entitled to reduction in fees based on the aforementioned allocation of expenditures, and will have the right to challenge the correctness of the allocation. The procedures for filing such challenges will be provided by my Local Union, upon request.

I have read and understand the options available to me and submit this application to be admitted as a member of the Local Union.

Last Name *

First Name *

Middle Initial

Occupation *

Street *

Member Street Address

Phone *

Member Phone

City *

Member City

State *

Member State

Zip Code *

Member Zip Code

Employer *

Employment Date *

Wage Rate *

Street *

Employer Street Address

Phone *

Employer Phone

City *

Employer City

State *

Employer State

Zip Code *

Employer Zip Code

Initiation Fee $

Paid to:

Local 142

Date of Birth *

Social Security Number *

Have you ever been a member of a Teamster Local Union: *

If yes, what Local Union No.

DATE OF APPLICATION *

SIGNATURE OF APPLICANT *

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* Required Fields

( DUES CHECKOFF)