I hereby join SHARE.

I understand that members are entitled to vote for and run for elected union positions, to vote on proposed contracts, and to participate in other union activities.

Completing this form authorizes UMass Memorial to deduct union dues from my wages and transmit them to SHARE.

Name

First Name

Last Name

Employee ID # (if known)

Department

Personal Email

Cell Phone

(###)

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Home Phone

(###)

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Work Phone

(###)

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date

MM

DD

YYYY

Signature