I hereby agree to forfeit all monies paid by me, along with all right to membership, if any of my answers are found to be untruthful, and further to accept and abide by the law set forth in the Constitution and By-Laws of this International.

This application will be actively considered for six months after it is filed. For consideration after that time a written request for reactivation is required. I authorize an inquiry to be made on the information contained in this application. Upon written request the nature and scope of this inquiry will be made available to me. Former employers named herein are authorized to give information regarding me. They are hereby released from all liability for issuing such information. I understand and agree that my employment is for no definite period and may regardless of the date of payment of my wages be terminated at any time without any previous notice. Either party may terminate the employment relationship at any time, with or without cause and with or without advance notice.