I, the undersigned, hereby apply for membership in the Western Washington Taxicab Operators Association, (WWTCOA). If admitted to membership, I agree to abide by the By-Laws of the Association.

I will faithfully perform all the duties assigned to me to the best of my ability. I will conduct myself at all times in a manner as not to bring reproach upon my Association. I understand that to remain a member in good standing that I must be current in my monthly dues and that failure to pay my monthly dues will result in my membership and privileges being revoked. I will never knowingly harm a fellow member, and I will never discriminate against a fellow driver on account of race, religion, sex, age, physical ability, sexual orientation, or national origin.

According to the information provided on this form, I hereby authorize WWTCOA to make withdrawals from my checking/savings account OR bill my credit card on a recurring monthly basis, for the purpose of dues collection. Monthly billing will occur between the 5th and the 10th of each month. I understand that should the monthly dues amount change in accordance with our governing documents the automatic withdrawal amount will be automatically updated to reflect this change, unless other- wise instructed by me, in writing. I acknowledge it is my responsibility to inform the union of any change to address or phone number within 15 days of such change.

I acknowledge that I am authorizing WWTCOA and Teamsters Local 117 to notify me via phone, text message, and email about issues involving the union or the association. I understand that I may terminate this agreement at any time by providing written notice not less than 5 days prior to the next scheduled withdrawal. This authorization is to remain in effect until the WWTCOA receives a written termination or change notice from me.