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Membership Application

Step 1 of 4

25%

Title(Required)

Cement Mason

Plasterer

Experience

Journeyperson

3rd Year Apprentice

2nd Year Apprentice

1st Year Apprentice

Pre-Apprentice

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City Province Postal Code

Date of Birth(Required)

MM slash DD slash YYYY

Gender(Required)

Male

Female

Non-Binary

Prefer Not to Say

S.I.N #(Required)

Primary Phone Number(Required)

Secondary Phone Number

Email Address(Required)

Former Member of OPCMIA(Required)

Yes

No

Local No.

Registration No.

Do you owe any outstanding FINES or DUES to your former local?

Yes

No

Please upload your resume

Max. file size: 50 MB.

Member Signature(Required)

Rate Your Ability

Proficiency in suspended slab or slab on grade concrete placement.(Required)

1 representing no experience and 5 representing extensive experience

1	2	3	4	5

Proficiency in hand finishing concrete slab.(Required)

1 representing no experience and 5 representing extensive experience

1	2	3	4	5

Experience in operating:(Required)

	Yes	No
Walk behind power trowel
Ride on power trowel
Roller Screed
Laser Screed
Gomaco

Proficiency in executing successful minor surface repair.(Required)

1 representing no experience and 5 representing extensive experience

1	2	3	4	5

Proficiency in successfully executing extensive surface or an integral repair.(Required)

1 representing no experience and 5 representing extensive experience

1	2	3	4	5

Ability to correctly set Curb & Gutter formwork(Required)

1 representing no experience and 5 representing extensive experience

1	2	3	4	5

Ability to perform tasks associated with placement and finishing of Curb & Gutter construction.(Required)

1 representing no experience and 5 representing extensive experience

1	2	3	4	5

Your ability to prep and install grout according to specifications.(Required)

1 representing no experience and 5 representing extensive experience

1	2	3	4	5

Number of years working as a Concrete Finisher?(Required)

1-5 Years	6-10 Years	11-15 Years	15-20 Years	21+ Years

What aspect of the trade are you currently working in?(Required)

Dry Finishing	Road Building	Flat Work	Decorative	Not in concrete

Would you be interested in another aspect of the trade if you became unemployed?

Yes

No

Do you have a Concrete Finisher Trades Certification or Red Seal Certification?(Required)

Yes

No

Canadian Application for Membership

In accordance with the International Constitution, when an applicant applies for membership in the International Association, the Financial-Secretary of the Local Union shall immediately forward to the International Association the applicant’s completed application form along with $275 fee to cover the costs of requests or search for records and registration.

OPCMIA International Consent(Required)

I agree to the privacy policy.

I promise and pledge my word of honor that I am familiar with the laws and Constitution of the International Association and of this Local Union and that I will not perform any acts in any way prejudicial to the best interests of the International Association, but will endeavor at all times to promote the International Association’s
prosperity and usefulness. I agree to remain loyal and true to the principles and policies and to be governed by the Constitution, by-laws and ritual of the International Association, and the local union, in any and all matters that now or may hereafter be included therein. I further promise and swear that I am not a member of any organization advocating the overthrow by force and violence of the Government of the (United States) (Canada). I take this obligation voluntarily, without any mental reservation, and I will, to the best of my ability, faithfully meet all obligations and discharge of my duties as a member of this association which I am about to enter, so help me God.

I, the undersigned, of my own free will and accord, respectfully make Application for Membership as stated above and hereby declare the above to be a true statement of facts and if at any time it should be proven otherwise the Local Union/International has the right to cancel my membership and all monies paid forfeited.

If this membership application is accepted, I also hereby authorize the Operative Plasterers’ and Cement Masons’ International Association of the United States and Canada and its local unions to act for me as my exclusive collective bargaining representative in all matters pertaining to wages, hours, and other conditions of employment, with my current employer, as well as all other employers for whom I may become employed after this date, on all present and future job sites. I understand that this card may be used to obtain recognition from my current or future employer without an election. This authorization is non-expiring, binding and valid until such time as I revoke it by notice in writing to both my local union and the OPCMIA.

Member Signature(Required)

Electronic and Telecommunication Authorization

I recognize that technology is ever-evolving and that electronic communications cannot be fully protected from unauthorized interception. Understanding the risk of electronic communication via email or texting, I have indicated my preferences and consent for the following communication methods:

Email Consent(Required)

I give my consent for the OPCMIA, Local 919 to communicate with me by email

Use the following email address(Required)

Text Message Consent(Required)

I give my consent for the OPCMIA, Local 919 to send me information and reminders via text message

Use the following cellular phone(Required)

Hidden

Application Date

MM slash DD slash YYYY

Member Signature(Required)

Operative Cement Masons’ and Plasterers’ International Association of the United States and Canada, Local 919

12309 Industrial Road
Surrey, British Columbia, Canada

Tel: 604-585-9198
Email: [email protected]

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