Congratulations on your Union Job!

Name*

First Last

Employee ID#

Date of Birth*

SSN*

Enter SSN Confirm SSN

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Personal Phone*

Personal Email*

Employer*

Employer Category

County of San Bernardino
City Agency
Other

Department*

Job Title*

Work Address (Optional)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Previous Employer

$5,000 life insurance benefit free to Teamster members — Beneficiary Name*

AUTHORIZATION*

I recognize the need for a strong union and believe everyone represented by our union should pay their fair share to support our union’s activities. Therefore, I voluntarily authorize my employer to deduct from my earnings and transfer to Teamsters Local 1932 an amount equal to the regular monthly dues uniformly applicable to members of Local 1932 and also understand that I am responsible to pay for any transfer fees and/or unpaid dues from any other Teamsters Local that I belonged to. I agree that this authorization shall remain in effect for the duration of the existing collective bargaining agreement, if any, and yearly thereafter until a new CBA is ratified, unless I give my written notice via U.S. mail to both the employer and Local 1932 during the 30 days prior to the expiration of the CBA or, if none, the end of the yearly period. My check-off authorization will renew automatically, regardless of my membership status, unless revoked during the window period described. My authorization below strengthens our Union to win fair wages and benefits! As a member in good standing, I proudly pledge to faithfully uphold the Constitution and Bylaws of the International Brotherhood of Teamsters and Local 1932. I will faithfully perform any duties entrusted to me to the best of my ability. I will conduct myself at all times in a manner as not to bring reproach upon my Union. I am proud to join with my Union Sisters and Brothers to accept my responsibilities during any authorized strike or lockout. As a member in-good-standing, I shall be entitled to all of the rights and privileges of membership!