I, the undersigned, hereby apply for admission to membership in the Teamsters Local Union 577 and voluntarily choose and designate it as my representative for purposes of collective bargaining, hereby revoking any contrary designation. If admitted to membership, I agree to abide by the Constitution of the International as well as the Local Union Bylaws which are not in conflict with International laws and thereupon accept and assume the following oath of obligation:

     I pledge my honor to faithfully observe the Constitution and laws of the International Brotherhood of Teamsters, I pledge that I will comply with all the rules and regulations for the government of the International Union and this Local Union. I will faithfully perform all of the duties assigned to me to the best of my ability and skill. I will conduct myself at all times in a manner as not to bring reproach upon my Union. I shall take an affirmative part in the business and activities of the Union and accept and discharge my responsibilities during any authorized strike or lockout. I will never discriminate against a fellow worker on account of creed, color or nationality. I will at all times bear due and faithful allegiance to the International Brotherhood of Teamsters and this Local Union. PRINTED IN U.S.A

CHECK OFF AUTHORIZATION AND ASSIGNMENT

I (enter full name here:)  
hereby authorize my employer to deduct from my wages each and every month or week (as agreed to by Local 577) my Union dues consisting of initiation fees, monthly fees, and uniform assessments owing to Local Union 577 as a result of membership therein or if I should determine at any time not to be a Union member, an equal amount which I understand and acknowledge to be my fair share of expenses reasonably incurred by the Union in representing my bargaining unit and conducting other necessary and related programs, and business which enhance and assure that representation, and direct that such amount to be deducted be sent to the Secretary-Treasurer of Local Union 577 for and on my behalf.

     This authorization is voluntary in consideration for the cost of representation and collective bargaining and is not conditioned on my present or future membership in the Union.

     This authorization and assignment shall be irrevocable for the term of the applicable contract between the Union and the Employer or for one year, whichever is the lesser, and shall automatically renew itself for successive yearly or applicable contract periods thereafter, whichever is lesser, unless I give written notice to the Company and the Union at least sixty (60) days. but not more than seventy five (75) days before any periodic renewal date of this authorization and assignment of my desire to revoke same.

     I authorize Local Union 577 to enforce and transfer this Authorization to any Employer that it has under contract, including my present Employer. should I terminate my employment and be re-employed in the future. I further agree that, due to my negligence, should I not comply with the terms of this authorization and assignment. I will accept liability for any and all initiation fees, dues and assessments retroactive for any negligent period.