united@work
www.novaunion.com

Nova Union of Teachers
Affiliated with the National Union of General Workers (NUGW) Tokyo District South
NUGW, 2F Kobayashi Building,5-17-7 Shimbashi, Minato-ku, Tokyo 105-0004

Please print and fill out this form and fax it to 03-5748-1564
or mail it to NUGW

Application for Union Membership

Name:

Email:

Tel/Fax:

Address:

Nova Branch:

Job Title:

Contract from (d/m/y):

Years employed:

Signed: