DEPED TEACHERS’ UNION MEMBERSHIP AND AUTHORIZATION FORM

Personal Details of Applicant:

Surname: Given Name: Middle Name:

Employer School/Unit: Employee ID Years of Service in Birth Date:

No.: Present
School/Unit:

Position in Employer Residence Address: Email address:

School/Unit:

Telephone No.: Are you a member of any labor union?:

Present Employment Status: Have you been a member of any labor union?
Permanent ___ Please indicate the name and reason for
Temporary ___ cessation of membership:
Part Time ___

AUTHORIZATION

I hereby confirm that the above details are true and correct, that I have read and
understood the Constitution and By-laws of DepEd Teachers' Union (DTU), and that I wish
to join DTU subject to the union’s Constitution and By-laws and the rules that may be
promulgated by DTU. If accepted as a member, I hereby: (a) undertake to abide loyally by
DTU’s Constitution and By-laws and DTU’s membership rules, (b) undertake to faithfully
discharge the rights, duties and responsibilities of a member of DTU; (c) declare that I shall
do my best to carry out my duties as a teacher in accordance with DTU’s principles, and to
promote its objectives and interests; and (d) authorize DTU to represent me in any
negotiations, talks, and agreements with my employer, concerning compensation, benefits,
labor standards, and other conditions of employment.

Signature over Printed Name Membership Approval By:

of Applicant
Date:_____________ _________________________________
Signature over Printed Name
of Approver
Date: ____________

SUBSCRIBED AND SWORN to before me this _____ day of _____, affiant exhibiting
to me his/her __________________ issued on _________________ at
____________________________.

Doc. No.: ____;

Page No.: ____;
Book No.:____;
Series of 2019.