T.U.I.
MEMBERSHIP APPLICATION:
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Surname _____________________________________________
 First Name: _____________________________________________
 DOB:__________
School: Phone: Fax: _________ /_________ _________
Email: _________ _________

Home: Phone: Fax: _________ /_________ _________
Email: _________ _________
School Address:
_____________________________________________
_____________________________________________
Home Address:
____________________________________________
_____________________________________________
Teacher of: _____________________________________________
Qualifications _____________________________________________
Status:     PWT:     TWT      EPT     PTF     PT
(PLEASE CIRCLE)    
Are you at present, or have you previously been a member of TUI ?
Yes / No
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 New Members: I hereby apply for membership of the Teachers' Union of Ireland, and, if accepted, agree to be bound to the rules of the Union, now inforce, and as may be amended.
Signed: _______________________________
Date: _________________________________
Proposed by:______________________________
Seconded by:____________________________
Accepted by the Branch on:_________________________________