Membership Application – UFCW Local 888

Social Security Number *

First Name *

MI

Last Name *

Date of Birth *

Gender *

Male
Female
Other

Marital Status *

Single
Married
Divorced

Email and Cell Phone Communication Agreement *

I have read and agree.

By providing a cell number, I agree that my UFCW Local 888 and International Union can send me auto-dialed calls and texts, and other communications. I reserve the right to opt-out. Carrier data and message rates may apply.

By providing your E-MAIL you are authorizing UFCW Local 888 to communicate via electronic mail. By agreeing to accept e-mail communications, I understand that I am also authorizing UFCW Local 888 to retain my e-mail address in its database so that it may send me future communications. I acknowledge and understand that the e-mail messages sent to me are not encrypted and travel over the internet, resulting in a risk that any e-mail will be intercepted and read by Third parties to whom the e-mail is not directed. I hereby assume the foregoing risk.

Email *

Cell Phone *

Home Phone

Mailing Address

Address *

Apt./Suite

City *

State *

Zip Code *

Company Name *

Store/Plant # or ID

Company Address *

Hire Date *

Job Title

Department

Shift *

Full Time
Part Time

Language Preference *

English
Spanish
Other

Optional: Signup for UFCW Active Ballot Club Political Checkoff *

Yes
No

UFCW CHECK-OFF AUTHORIZATION *

I have read and agree.

I authorize my employer to deduct from my wages an amount equivalent to dues, initiation fees, and assessments as shall be certified by the Secretary- Treasurer of Local 888 of the UFCW, AFL-CIO and remit same to said Secretary-Treasurer.

This authorization is voluntarily made and is not contingent upon my present or future membership in the UFCW. The Secretary-Treasurer of Local 888 is authorized to provide this authorization to any employer under contract with my Local 888, and is further authorized to transfer this authorization to any employer under contract with my Local 888 that hires or rehires me in the future, and it will be binding on me and my employer.

This authorization shall be irrevocable for the period of one year from the date I sign this authorization, or until the termination of the applicable collective agreement between Local 888 and my employer, whichever occurs sooner; and I agree and direct that this authorization shall be automatically renewed, and shall be irrevocable for successive one-year periods or for the period of each succeeding applicable collective agreement, whichever shall be shorter. To revoke this authorization, I agree that I will give written, signed notice to Local 888 and my employer not more than 45 days and not less than 30 days prior to (i) the end of the initial or any successive one-year period, or (ii) the termination of my initial or any successive collective agreement, whichever occurs sooner.

Should any part of this authorization be declared invalid or unenforceable by a legitimate court, the remaining parts shall be binding on all parties concerned.

Union Application Agreement *

I have read and agree.

I am applying for UFCW Local 888 membership and I authorize UFCW Local 888 to represent me on the job.

Signature *

Clear Signature

Draw signature with your finger or mouse.

Date Signed *