Membership Application

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    First Name:


    Last/Family Name:


    Email Address:

    Phone (e.g. 090-9999-9999):

    Region:

    Post Code (e.g. 530-0041):

    Prefecture:

    City (e.g. Osaka-shi) (*Kanto addresses may not have this):

    Ward (e.g. Kita-ku):

    District or Other Address Info (e.g. Ikoma-gun, Imazu, Takagamine) (*some addresses do not have this):

    Street Address (e.g. Nakano-cho 1-6-8):

    Apartment Name and Room Number (e.g. Tenma Bldg 203):

    Monthly Dues Rate (dues are based on your yearly income before taxes and after bonuses, see Membership -> Dues for more info):

    How Did You Hear About Us?:

    Is there a specific reason why you would like to join?:

    Name of MAIN workplace (e.g. ABC Company) (where you work the most):

    What Type of Industry Do You Work In?:

    At this workplace I am......
    DispatchedDirectly HiredI Don't Know
    Please List Your Other Workplaces (separated by a comma) (e.g. Kindai, Kangaku, ECC):

    What labor issues are you most concerned about?:

    I'd like more info about:

    Duties of membership

    Please click to state that you understand and agree before submitting the application.
    1. Keeping your dues paid up to date, and paying by an automatic process such as checkoff, bank debit, or PayPal transfer.
    2. Participating in your own branch, attending your branch meetings and branch annual general meeting (online participation is usually an option).
    3. Supporting fellow union members (from all union branches) who are in dispute with their employer (this does not mean that you are required to go on strike to support members in other workplaces).