Your Workplace

QUESTIONNAIRE FOR INTERESTED NEW MEMBERSHIP GROUP

This questionnaire below is designed to assist NUPE in considering applications for membership from new members and membership groups. We would appreciate if you could take the time to answer the questions below so that the NUPE Executive Committee can consider our ability to effectively and appropriately service your membership needs. If you prefer, you may fill out a print version of the questionnaire and send it to us as listed on the last page.

1. Employment information:

Name of Organisation

Division/Department(s)

Location

2. Please briefly note occupational groups and numbers interested in NUPE:

Occupational Group

Numbers

3. Are employees currently a member of a union?

Yes

Please state union(s):

4. Are employees currently on a Collective Employment Agreement?

Yes

Expiry date of CEA:

(If possible please forward a copy of the Collective Employment Agreement or Individual Employment Agreement)

5. What are the current issues for employees in your organisation?

6. Please describe briefly below the service you would expect from the union:

Face to face meetings/visits with organisers:

Newsletters/information:

Collective Representation (e.g. reviews and formal consultation):

Other (Please specify):

7. Are there any current or future issues that you would like the union to take up on your behalf that are not noted in Question 6 above?

Yes

8. If YES please briefly note these below:

Description

Expected timeframe (month/year)

9. What has prompted you to consider joining NUPE?

10. How did you find out about NUPE?

11. Please note below any further information that you require about NUPE that we can respond to:

Contact Details for Nominated Contact Person/Interested Member:

Dr Miss Mrs Ms Mr

(first names)

(surname)

Home Address:

Home Phone:

Fax:

Home Email:

Employer:

Employer's Address:

Department/Division:

Workplace

Job Title:

Work Phone:

Fax:

Work Email:

Thanks. We will be in touch soon. Please type the security letters and numbers that you can see in the image below. You don't need capitals. This helps to ensure the integrity of your questionnaire.

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Thank you for taking the time to complete this questionnaire. Your interest in joining NUPE is important to us and the above information will assist our Executive Committee in their consideration of your application for membership.

Regards Martin Cooney
Acting National Secretary
National Union of Public Employees

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