Membership Card Application

Submission
- I would like to update my information and have a new (or replacement) card sent to me.
- I would like to update my information with the Union only.
A replacement card should be issued to you if: (1) You've misplaced your card; (2) Your name has legally changed; or (3) You've changed bargaining units (i.e. previously Edmonton Public Library, now City of Edmonton).
Name*
First Last
Bargaining Unit*
Employee ID / Payroll Number*
Department and Section*
Position or Job Title
Work Phone*
Work Address (include floor if applicable)*
Street Address Address Line 2 City Province Postal Code
Shop Steward’s Name or Mailout Representative's Name
Your Shop Steward or Mailout Representative is usually the person who receives and distributes Union mail in your area. If unknown, leave blank.
Home Address*
Street Address Address Line 2 City Province Postal Code
Home Phone
Cell Phone
Email Address (Personal Non-Work)
Consent*
- I Consent to the Collection, Use and Disclosure of Personal Information
Consent to the Collection, Use and Disclosure of Personal Information: By clicking this checkbox, I agree that Civic Service Union 52 may collect, use and disclose personal information insofar as such information relates to the obtaining, managing and maintaining of my employment within the contractual unit represented by CSU 52 and insofar as it relates to the administration of the collective agreement, to collective bargaining and to the administration of CSU 52.
Name
This field is for validation purposes and should be left unchanged.