National Union of Hospital and Health Care Employees
District 1199NM
  • June 15, 2021
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  • National Union of Hospital and Health Care Employees, District 1199NM
    AFSCME, AFL-CIO 130 Alvarado NE Suite 100, Albuquerque NM 87108-1602
    Application For Membership


    First Name: *
    Middle Initial:
    Last Name:*
    Address: *
    Apt:
    City: *
    State: *
    Zip: *
    Employed At: *
    Dept.: *
    Title: *
    Hourly Salary $: *
    Hours Per Week: *
    Date Hired: *
    Shift: *
    Cell Phone: *
    Home Phone: *
    Personal Email: *

    ID #:
    Date:
    06/15/2021
    I hereby accept membership in the National Union of Hospital and Health Care Employees, AFSCME, AFL-CIO, and designate said Union to act for me as collective bargaining agent in all matters pertaining to conditions of employment. I hereby pledge to abide by the Constitution and By-Laws of District 1199NM, the National Union of Hospital and Health Care Employees, AFSCME, AFL-CIO.
    Signature: *

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    *- Required

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