Enrolment Card

Title

Home Address

City

Province

Postal Code

HOME E-mail

HOME Tel. No.

Cell No.

Date of Birth

Gender

Language Preference

Employment Date

R/B/I

Building

Room

Group

OP Group - Sub Group

Level

Position

I agree to become a member of the Research Council Employees' Association and wish that it represent me as my bargaining agent.

Please check the box if you agree.