Membership Change of Address Form

Agriculture Union members can and do often move - from job to job, office to office and city to city. The employer does not provide the Union with this information.

We can't provide you with representation and services if we don't know where you are!  If you, or another Agriculture Union member you know, need to change their union contact information, please make use of the electronic Change of Address form by clicking on the appropriate icon in the right-hand column of this page.

Once this form is completed, a click of the mouse will send it to our National Office. That's all it takes!

Member Address Change Form
 
PSAC ID:

Salutation:
First Name:
Last Name:
Old Home Address 1:
Old Home Address 2:
Old City:
Old Province:
Old Postal Code:
 
New Home Address 1:
New Home Address 2:
New City:
New Province:
New Postal Code:
 
Telephone (Home):
 123-456-7890
Telephone (Work):
 123-456-7890 ext 111
E-mail:
Fax (Home):
 123-456-7890
Fax (Work):
 123-456-7890
Local:
IAN #:
Employer / Dept:
Language:
 English French
   
Comments:
 

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