I, the undersigned, apply for membership in ..............
..............
(name of the union)
the head office of which is at ..............
I undertake to comply with the by-laws of the union and I subscribe for .............. shares of $5 each payable as follows: ..............
I also undertake to pay the sum of .............. as the amount of the cost of acquisition of the shares I have subscribed for, payable as follows: ..............
My liability as a member is limited to the amount I shall have paid on my shares, not to the amount I have subscribed for.
I may cancel my subscription for shares within 30 days of the signature of this application by giving a written notice to that effect to the union in accordance with section 10 of the Act.
Signed in duplicate at .............. this .............. 20..............
Witness ..............
(signature)
..............
(signature)
Address ..............
Occupation ..............
Accepted by the board of directors, this .............. 20..............
..............
(signature of authorized person)