Lodge 92 Labor Services
Lodge 92 Labor Services
 

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FOP LODGE 92 Labor Services
Membership Application
PO BOX 683, Blue Bell, PA 19422


Application

YES! I want to join my fellow employees and become a member of FOP Lodge 92 Labor Services. I request and voluntarily authorize my employer , The Commonwealth of Pennsylvania to deduct from my earnings and pay an amount equal to Lodge 92’s regular dues. This dues deduction authorization shall remain in effect, regardless of whether I remain a member of the Union, for a period of one year from the date of execution and will renew automatically from year to year as long as my employment continues, unless I revoke it by providing notice to Lodge 92 Labor Services via U.S. mail within the 30-day period before the anniversary date of this agreement. I acknowledge that my dues deduction authorization is a contractual agreement between myself, as a bargaining unit employee, and FOP Lodge 92 Labor Services, separate from any statutory provisions. Authorization is not a condition of employment, and I can decline to agree to it without reprisal.

First Name *
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Last Name *
Home Address *
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Postal Code *
Email *
Cell Phone *
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Last 4 SSN *
Employee Number *
Birth Date *
Hire Date *
Agency *
Job Title *
Work Location
Are you currently a Member of an FOP Lodge? *
Authorize Agreement *
BY SIGNING THIS DOCUMENT ELECTRONICALLY, I CONSENT TO ENTER INTO THIS AGREEMENT FOR AUTHORIZATION OF DUES DEDUCTION WITH THE LOCAL UNION. I HAVE READ, UNDERSTAND, AND SUBMIT THIS APPLICATION TO BE ADMITTED AS A MEMBER OF THE FOP LODGE 92 LABOR SERVICES UNION.
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Lodge 92 Labor Services
PO BOX 683
Blue Bell, PA 19422
  ‪(717) 461-3497‬

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