New Member Application (online)

COWUMA MEMBERSHIP & STOP ORDER FORM
Commercial, Industrial & Allied Workers Union Members Association
NAME OF OFFICER:
DATE OF BIRTH:
GENDER:
REGION:
EMPLOYER:
JOB TITLE:
EMP. NO:
DEPT:
WORK ADDRESS:
WORK TELEPHONE:
FAX:
WORK E-MAIL:
PERSONAL MOBILE:
PERSONAL EMAIL:
BASIC PAY:
Monthly dues (1%): –
EMPLOYMENT DATE:
UNION JOINING DATE: