[B] Application for CPSU Membership

Community & Public Sector Union
(SPSF Group NSW Branch)
ABN: 11 681 811 732

To be returned to Membership Section, PSA/CPSU, GPO Box 3365, Sydney 2001 for processing.

(Please use BLOCK letters or type all details)

I,

I understand that:

1. If I am a member of the PSA, then the PSA will pay to CPSU the monies payable in respect of my membership

2. If I am not a member of the PSA, I agree to pay the CPSU the monies in respect of CPSU membership. (Note, the CPSU fees for persons not in the PSA are the same as the PSA fees).

3. Resignation: the same conditions as for the PSA apply. See Conditions of Resignation. A resignation from the PSA will be taken as a resignation from CPSU, subject to confirmation.

I agree that a copy of this form (whether copied by photocopy, microfilm, facsimile or otherwise) may be used or dealt with as if it were the original.


Signature

Date _______/_______/________

When you have read the obligations print out this form, complete it, then sign it.

The completed form must be posted to us at the above address as we need your signature.