Queensland Police Union of Employees

217 North Quay Brisbane

Brisbane QLD 4003

Phone: (07) 3259 1900 Fax: (07) 3259 1950

Schedule A:
Queensland Police Union of Employees Application for Membership (Schedule 5)

Title
Registration Number
Surname
Given Names
Postal Address		Post Code
Residential Address		Post Code

If you wish to become a member of the Queensland Police Union of Employees.
The Queensland Police Union is hereby authorised for all industrial matters to make or sign any document process or step and/or appear and act as agent for the term of my membership.
I undertake to pay all dues and levies struck in accordance with the rules of the QPUE.
I agree to abide by the rules of the QPUE.
I understand that my financial obligations are to pay fees to the QPUE in accordance with the rules of the Union and that relevant rules concerning those obligations are contained within Rule 6 of the Rules of the Union.
I understand that as a member of the QPUE I will also be a member of the Police Federation of Australia, Queensland Police Branch.
I understand that as a financial member, I may resign from the Membership of the QPUE by notice in writing addressed to the General Secretary

Signed - Enter Your Full Name
Date of Joining

MEMBERSHIP DETAILS

Registered Number
Date Of Birth
Home Phone Number
Mobile Phone Number
Home Email Address
Work Email Address
Academy Start Date
Date Sworn In
Rank
Squad Number
Stationed

To Register for the QPUE Secure Webpage please supply your details below:

Username
Password
Type Password Again

AUTHORITY TO PAY UNION DUES BY PAYROLL DEDUCTION

You are hereby authorised to pay the Queensland Police Union of Employees by fortnightly instalments my Union dues as indicated below. Approval is also given to alter the deduction in accordance with changes to annual dues.

This authority is to commence fortwith and shall remain in force until cancelled by me in writing.

	Police Recruit	$19.90
	Police Officer	$39.80
	Plo/Pipe Band (Non Sworn)	$27.85
	Assistant WatchHouse Officer	$27.85
	Plo/Pipe Band (Part Time)	$20.05
	Part Time (2 - 64 Hours per F/Night)	$28.65
	Additional Ammount

Northern

Central

Southern

Brisbane

South Eastern

Station
Work Address
Work Phone
Work Mobile Phone
Comments *

You may lodge this form electronically by emailing it to qpu.asn.au

It is not necessary for you to sign the form if you email it to the above address from your QPS email account.

By emailing this form to the above address from your QPS email account, you agreed to recieve comunications from Queensland Police Union, you certify the content of the form is correct; that you are authorised to sign the form; that you are bound by the agreement herein; and that you authorise the QPS (or PSBA) to act upon this electronically submitted form to the same extent it otherwise could have if you had personally signed it.