Join the CWU NSW T&S Branch

I hereby make an application to be admitted as a member of the Communications Workers Union (CWU) T&S Branch(NSW) and undertake to abide by the Rules and By-Laws and any amendments thereof, made in accordance with the provisions of the Workplace Relations Act, and registered thereunder.



Name On Credit Card:*
Credit Card Number:*
Credit Card Type:*
Expiration Date:*
CVC Code:*			3 digit code on the back of the card.

I authorise the CWU NSW Telecommunications & Branch to debit my credit card for the amount of my union dues , which will be charged on a frequency selected above and will be adjusted if union dues change.

I Accept: *

Institution Name:*
Account Name:*
BSB:*
Account Number:*

I/We request you, until further notice in writing, to debit to my/our account, described in the schedule below, any amounts which the CWU, NSW Telecommunications & Services Branch (ID no. 000654) may debit or charge me/us through the Direct Debit System. I understand and acknowledge that: (1) The bank/financial institution may in its absolute discretion determine the order of priority of payment by it of any moneys pursuant to this request or any authority or mandate. (2) The bank/financial institution may in its absolute discretion at any time by notice in writing to me/us terminate this request as to future debits. (3) The user may, by prior arrangement and advice to me/us vary the amount and frequency of future debits, which will be charged on a frequency you selected above.

I Accept: *

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First name:*
Last name:*
Private Address:*
Suburb/Town:*
State:*
Postcode:*
Home Telephone number:*
Personal Mobile:*
Date Of Birth:		in the format dd/mm/yyyy
Personal E-mail:*
Gender:*	Male Female

Employer:*
Position Title:*
Employee Number:
Employment Status:*	Permanent Part Time Casual Contractor
Work Section:*
Work Address:*
Suburb/Town:*
State:*
Postcode:*
Work Telephone number:*
Work Mobile:*
Work E-mail:*

Payment Type:*
Pre-Tax Salary:*			do not enter with "$" or spaces.
Payment Frequency:*
Frequency & Payment:*

Membership Application