Membership Application

    Pre-existing matters: By ticking this box, I acknowledge that the Communication Worked Union may not assist with any matters that may have arisen prior to making this application for membership, unless, expressly agreed to by the Branch Secretary and/or the Branch committee of management.
     
    MR MRS MS MISS

    Employment arrangement

     
     

     


     

    Payment method 1 Direct Debit from bank/Financial Institution Account

    Customer's Authority

    Authorise and request the CEPU Communication Division, Western Australia, APCA User ID 025934, to arrange for funds to be debited from my/our account at the financial institution identified below and as prescribed through the Bulk Electronic Clearing System and vary the amount from time to time in accordance with the rates of contribution as per the registered rules of the organisation. I/We also authorise the Debit User to verify the details of the below account with my/our financial institution to release information allowing the Debit User to verify the below account details.
    Bank/Financial Insutution NAME

    Payment method 2 Direct Debit from Credit /Debit Card Account

    Credit Card Details

    DEBIT FREQUENCY:
    I hereby authorize CEPU Communications Division, Western Australia, To debit the abovementioned card with the amount prescribed in accordance with the Rules of the Organisation and at the intervals specified above. The authority shall stand, in respect of the above specified card and in the respect of any card issue to me in renewal or replacement thereof, until I notify the CEPU in writing of it cancellation.

    CARD HOLDER NAME