The Coalition of Black Trade Unionists

New Member   Renewal of Prior Membership

Date: 

Name:

Address:
                 

City: State: Zip Code:

Home Phone:

Work Phone:

Cell Phone:

E-Mail Address:

Union Affiliation:

Position:

Membership Dues (per year) includes membership in
the Local Chapter and National CBTU
 Rank and File - $40.                      
 Officers - $75.                                
 International Officers - $150.         
Retiree (one-half of the Chapter's
dues at time of retirement)

Make Checks of Money Orders payable to S.E. PA. CHAPTER, CBTU

Mail to: Coalition of Black Trade Unionists (CBTU)
P.O. Box 42536
Philadelphia, Pennsylvania 19101

Please print and mail this application with your check or money order.