Private Security Sector Forum SA

Indepent workers Alliance union

Membership Application form
OUR contact details

4 Fore Street ,Stats Building ,

Suite 28,2nd floor

Alberton

076 2576093

workersforums@gmail.com/ workersforum4@gmail.com
Full Name

First NameLast Name
I'd number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
E-mail
example@example.com
Employment status
Employer Details
How will you like to pay your contributions
Bank details
Will you be willing to recommend us?
Were you a member of a union and which position did you hold?
Have resigned from the previous union.when last did they deduct their last contribution you made?

Please give reference beneficiaries :

Membership type
membership type and benefits( choose only1)

1. Enhanced R120 pm

Lawyer for any dispute

Funeral cover

Martinity benefit for both gender

Accidental benefit

Legal helpline

Retirement benefit of R30000

2. Basic R100 monthly contribution

Legal helpline on work desputes only

Union representative

Funeral cover

Accidental benefit

Retirement benefit of R30000

3. Apprehentice R60

Legal helpline

Union representative

Funeral cover

4 Affiliate 60

5. Associate/premier 300 per 15 members

Nb.. You can choose for us not to pay for funeral cover and instead pay your credits when you are no more .same amount to be paid for funeral cover.eg mortgage bond, furniture credit, loan etc.
Applicant Declaration

I hereby request and accept membership in the workers forum " private security sector forum sa " / union " independent workers Alliance union .I authorized Pssfsa/IWAU to act as my inclusive bargaining agent in all matters pertaining to my relationship with my employer.i solemnly promise to uphold and obey the constitution and bylaws of the forum and union, to assist my fellow members to improve their economic ,political and social condition, to uphold the principle of democracy and fair play, and to do not deliberately wrong or harm any member of this Union.
Signature
Date

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Date
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Indepent workers Alliance union