APPLICATION FOR IWW MEMBERSHIP 

TO JOIN:  Mail this form with a check or money order (in US Dollars) for
initiation and your first month’s dues to:  

IWW, PO Box 23085, Cincinnati, OH 45223-3085, USA.

Initiation is the same as one month’s dues.  Our dues are calculated
according to your income.  If you monthly income is:

Less than $1000 (US), dues are $6 per month;
Between $1000 - $2000 (US), dues are $12 per month;
Greater than $2000 (US), dues are $18 per month.

You may pay as many months’ dues in advance as you wish, but please do not
send partial payments.  If you round up, your remainder will be considered
a donation.  

[ ] I affirm that I am a worker, and that I am not an employer or police
    officer
[ ] I agree to abide by the IWW Constitution;
[ ] I will study the organizations’ principles and make myself acquainted
    with its purposes.

Name (or Pseudonym): _______________________________

Address: ___________________________________________

City, State / Province, Postal Code  

____________________________________________________

Country: _____________________________ 

Phone Number________________________________________ 

e-mail: ____________________________________________

Occupation _________________________________________ 

Monthly Take-home Pay: _____________________________

Initiation Fee $____________ Dues $ ________________  

Total Amount Enclosed $_____________________________