CBTU Membership Application

If you desire to become a member, please fill out this form, print and mail to the address below. Make checks or money orders payable to the Coalition of Black Trade Unionists.

Date:

Rank and File- $30.00

Staff - $75.00

International Officer - $150.00

Retired Rank and File - $15.00

Retired Staff - $37.50 Retired Int'l Officer - $75.00

Information Only

Name

 

 

Address

 

City

 

 

State

 

 

Zip

 

 

Telephone

 


 

Email

 

 

Union Affiliation

 

Renewal of Prior Membership

Change of Address

New Membership

Mail to:
Coalition of Black Trade Unionists
P.O. Box 66268
Washington, DC 20036-6268