JOIN YOUR UNION Improving the lives of Australian care workers for over 112 years!ACWU MEMBERSHIP SUBSCRIPTIONS ARE 100% TAX DEDUCTIBLE! Full Time Worker Subscription Rate $12.50 per week Includes GST. Effective from 1 January 2023 Pay weekly Pay fortnightly Pay monthly Pay yearly Part Time / Casual Worker Subscription Rate $10.10 per week Includes GST. Effective from 1 January 2023 Pay weekly Pay fortnightly Pay monthly Pay yearly ACWU Membership Application Form Please complete all information. Step 1 of 4 25% HiddenNext Steps: Install the User Registration Add-OnThis form requires the Gravity Forms User Registration Add-On. Important: Delete this tip before you publish the form.Name(Required) First Last Email(Required) Enter Email Confirm Email Date of Birth(Required) DD slash MM slash YYYY Mobile Phone(Required)Home PhoneAddress(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Employment Status(Required) Full Time Part Time Casual How many hours do you work weekly?(Required)More than 26 hoursLess than 26 hoursWorkplace Name(Required) Occupation/Classification(Required) Workplace Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Do you have a secondary workplace?(Required) Yes No Secondary Workplace Name(Required) Secondary Occupation/Classification(Required) Secondary Workplace Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Payment Method(Required) Direct Debit Debit / Credit Card Name of Financial Institution(Required) BSB(Required) Account Number(Required) Account Holder Name(Required) First Last Card Type(Required) Mastercard Visa Card Holder Name(Required) First Last 16 Digit Card Number(Required) Expiry Month(Required) Expiry Year(Required) Do you have a workplace issue that requires immediate union assistance?(Required) Pre-existing issue None Specified Please provide details of your existing issue:Referred byPlease state the name of the person or workplace delegate who has encouraged you to join the Health Workers Union. First Last Terms of Service(Required)Application for membership I hereby apply for membership of the Health Services Union Victorian No. 1 Branch, trading as the Health Workers Union (HWU), and agree, if admitted, to abide by the rules and regulations adopted by the organisation. I also hereby nominate and authorise the HWU to act as my exclusive representative or bargaining agent for all purposes (including negotiation) associated with any workplace agreement that may be proposed to regulate the terms and conditions of my employment (current and future). This authorisation will remain in force until I withdraw it by giving the HWU notice in writing of my intention to do so. An applicant for membership shall not be entitled to the benefits of membership until they have received their membership number. The first applicable subscription will ordinarily be paid within five (5) business days of the membership being processed, unless another date is nominated by the prospective member. Once the membership application is received, it will be processed and considered by the Secretary of the HWU or the Branch Committee of Management as appropriate, membership benefits are applicable from the date of joining while the member continues to be fully financial. I acknowledge that membership benefits are subject to the terms, conditions and policies of the HWU. Privacy Statement The HWU collects personal information from members in order to best represent their industrial and professional interests. We are committed to protecting your privacy and providing you with information and services relevant to you. Personal information is protected by law and can only be released to other another person when you give permission or where required by law. Termination of Membership 1. A member may resign from membership of the Union by notice in writing addressed and delivered to the Secretary of the member’s Branch. 2. Where the member ceases to be eligible to become a member of the Union, the notice of resignation will take effect on the later of the following two dates: (i) on the day on which the notice is received; or (ii) on the day specified in the notice, which is a day not earlier than the day when the member ceased to be eligible to become a member. 3. Where the member has not ceased to be eligible to become a member of the Union, the notice of resignation will take effect on the later of the following two dates: (i) at the end of two weeks after the notice is received by the Union; or (ii) on the day specified in the notice. 4. A notice delivered to the Secretary of the member’s Branch shall be taken to have been received by the Union when it was delivered. 5. A notice of resignation that has been received by the Union shall not be invalid because it was not addressed and delivered in accordance with rule 10(b). 6. A resignation from membership of the Union shall be valid even if it is not affected otherwise in accordance with these rules if the member is informed in writing by or on behalf of the Union that the resignation has been accepted. I have read and agree to the terms of service listed above.NameThis field is for validation purposes and should be left unchanged.
