Application for Affiliation

Date:________________________________ 

Name of Organization:____________________________________________________

Address:_________________________________________________________________

City/Prov/Postal Code:___________________________________________________

The above named organization hereby makes application to be accepted into affiliation with the Peterborough and District Labour Council, P.O. Box 1928 Peterborough, Ontario K9J 7X7

Total membership of the applicant organization:________________________

It is understood that when this applicaiton is received and approved by the Labour Council, the applicant will be informed as to the entitled number of delegates and will be supplied with delegate credential and per capita tax forms.

Signed on behalf of
________________________________________________________________
(Name of Organization)

________________________________________________________________
(Signature)

President:____________________________________________________

Vice President:_______________________________________________

Recording Secretary:__________________________________________

Financial Secretary:__________________________________________

All correspondence for this organization to be sent to:

Name of Organization:____________________________________________________

Address:_________________________________________________________________

City/Prov/Postal Code:___________________________________________________

Phone / Fax Numbers:_____________________________________________________

Website / E-mail:________________________________________________________