Member Sign up - CFMEU WA

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First Name:* Enter your first name.

Last Name:* Enter your last name.

Preferred Nickname:

Email:* Enter your email address.

Mobile Number:* Enter your 10-digit mobile number (e.g. 0412345678).

Address:* Enter your address.

Suburb:* Enter your suburb.

State:* Select your state.

Postcode:* Enter your postcode.

Phone: Enter your Australian landline number (eg - 03-9699-0000).

Date of Birth:* Enter your date of birth.

Gender:* Select your gender.

Language:* Select your language.

Trade:* Select your trade.

Other Trade:* Enter your trade.

Onsite?*

Yes

Select if you work onsite.

Are you an Apprentice?*

Yes

Select if you are an apprentice.

Apprenticeship End Date:*

Job Site:

Employer:

Redundancy Number:

Superannuation Number:

Long Service Number:

Levie Programs:

Why are you joining CFMEU? * Select your reason for joining.

Agree to Terms: I accept the Member Terms , I am currently employed and I understand there are no refunds of membership fees. *

Preferred Nickname:

First Name:

Last Name:

Email:

Mobile:

Address:

Suburb:

State:

Postcode:

Phone:

Date of Birth:

Gender:

Language:

Trade:

Other Trade:

Apprentice:

Apprentice End Date:

Onsite:

Job Site Name:

Employer:

Redundancy Number:

Superanuation Number:

Long Service Number:

Levies:

Why are you joining CFMEU?:

Please ensure all your information is correct

Member Number: .....

Customer Reference Number (CRN): .....

Joining Fee: .....

Membership Fee: .....

Total Due: .....

WA

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