Membership application form

All fields marked with * are required. Your details are used only for union membership administration.

Section A: Personal information

Mr / Mrs / Ms

Surname *

First name(s) *

Initial(s)

Identity number *

Date of birth

Gender

New member

Section B: Contact details

A reliable address is needed to forward your membership card to you.

Postal address *

Address line 2

Suburb

City / town

Postal code

Tel. no. (home)

Cell no. *

E-mail

Section C: Details of your employment

Province *

Municipality / employer *

Department

Postal address of employer

Employer address line 2

Employer postal code

Staff no.

Section D: Banking details

Used for the monthly membership fee.

Account holder name *

Account number *

Account type *

Bank name *

Branch code

Section E: Declaration

I, the undersigned, hereby join the South African Municipal Workers' Union. As a member, I hereby:

Request that you deduct from my remuneration, in respect of subscriptions to the Union, an amount equivalent to 1% of my weekly / monthly remuneration, to the maximum of the prescribed amount per month or whichever amount the Central Executive Committee might decide on from time to time.
Request that in the event of a decision by the Union in terms of its Constitution, increasing the amount or imposing a levy, that such amount or levy be deducted from my remuneration.
Hereby revoke any previous authorisation for deductions on behalf of any other union or organisation.
Undertake that I shall give 6 (six) weeks' notice of resignation to the above union before revoking this authorisation, and that I shall duly inform my Payroll office thereof.

I confirm the information above is true and correct, I agree to the declaration above, and I consent to my personal information being processed for membership administration.

Signature of member (type your full name) *

Date *

Witness 1

Witness 2

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