NAPE Member Card Registration Form

NAPE Membership Card Registration Form

Please complete the application form accurately and to the best of your ability. If you have questions, please contact Betty or Mandy in Membership at bscurrey@nape.ca or mgalway@nape.ca or by phone at 1.800.563.4442

Personal Information
Name*
First Middle Last
Your Date of Birth*
Gender*
- Male
- Female
- Other
Your 4 digit NAPE Local Number (if you know it)
Please enter a number from 1000 to 9999.
Contact Information
Your Home Address*
Street Address Address Line 2 City Postal Code
Your HOME phone number
Your WORK phone number
Your CELL phone number
Your PERSONAL email address
Your WORK email address
Employer Information
Your employer*
Your work site (building/facility and address)
Your job classification (i.e. Clerk II, LPN I, Home Support Worker, Correctional Officer, Social Worker I, etc.):*
When did you start with this employer?
Your current Job Status*
- Permanent, full-time
- Permanent, part-time
- Temporary, full-time
- Temporary, part-time (including call-in)
- Seasonal
Consent and Confirmation*
I agree that the information provided is accurate and to the following statement:
"The information provided on this form is accurate and I hereby accept membership in the Newfoundland and Labrador Association of Public and Private Employees (hereafter: NAPE) and hereby authorize NAPE, its agents or representatives to represent me as the exclusive bargaining agent with my employer. I agree to abide by the By-laws and Constitution of NAPE, and I hereby authorize the Employer to release my employment-related information to NAPE."

NAPE Member Card Registration Form

NAPE Membership Card Registration Form

Personal Information

Contact Information

Employer Information

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NAPE Member Card Registration Form

NAPE Membership Card Registration Form

Personal Information

Contact Information

Employer Information

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Agreements

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