MOTION PICTURE STUDIO MECHANICS LOCAL SW 30th Ave. Fort Lauderdale, FL33312 Telephone (305) Fax (954)

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1 3780 SW 30th Ave. Fort Lauderdale, FL33312 Telephone (305) Fax (954) Dear 477 Applicant, Thank you for requesting membership with IATSE Local 477, "Florida's Professional Filmmakers". Please find enclosed documents that must be completed and returned via snail mail to our address listed above. They are as follows: 1. Authorization for Representation 2. Authorization for Work Dues Deductions (3% of gross) 3. Personal Information form 4. IATSE application -(use blue or black ink) completed to the line: DATED AT Application Fees are as follows: Initiation fee $ IATSE application Fee $ Two (2) quarters of per quarter $ Two-day OSHA 10 Training and Orientation $ Total due: $1, This offer valid for 30 days upon receipt of this document. Please return the following to us: All forms (International Application, Representation form, Work Dues Check Off and Personal Information sheet) A verifiable resume Payment for full amount of all fees, payable to IATSE Local 477 A copy of your FLORIDA driver's license Any license or certificates you have To complete the membership process, you will be required to successfully complete a 2-day OSHA 10/General Entertainment Industry training program, attend the New Member Orientation presentation, and receive the Obligation of Membership at a General Membership Meeting prior to receiving your Local 477 card. You must satisfy these requirements within six months after your application has been accepted.

2 MOTION&PICTURE&STUDIO&MECHANICS&LOCAL&477& 3780SW30thAvenueHollywood,FL33312& Tel:305=594=8585Fax:954=440=3362 AUTHORIZATIONFORDUESCHECKOFF Effectivedateofhire,IauthorizeandassigntoMotionPictureStudioMechanicsI.A.T.S.E.Local 477 three percent (3%) of all wages earned and to be earned by myself in the jurisdiction of Local477asanemployee,anddirectmyemployertodeductsaidthreepercent(3%)frommy wagesandremittolocal477. This assignment shall be irrevocable for a period consisting of either one (1) year or until terminationoftheapplicablecollectivebargainingagreement,whicheverissooner. EmployeeName: SocialSecurityNo. Date: Signature: ProjectName: ProductionCompany: Department:

3 3780 SW 30th Avenue Ft. Lauderdale, FL Tel: Fax: Personal Information First Middle Last Street Apt# City State Zip Phone Mobile Date of Birth Married Status Deductions Single Married Divorced Windowed Spouse Social Security List two (2) classification for with you are qualified. Classification 1 Classification 2 Other I.A.T.S.E Local Union(s) affiliation(s) Local Type City

4 3780%SW%30 th% Avenue%%Ft.%Lauderdale,%FL% 33312% Tel:%305<594<8585%% Fax:%954<440<3362% Authorization for Representation International Alliance of Theatrical Stage Employees Moving Pictures Technicians Artist and Allied crafts of the United States its Territories and Canada, AFL-CIO-CLC Designation of Collective Bargaining Representative and Application for Membership I, Of Print Name Address Telephone Address: Classifications: I hereby authorize International Alliance of Theatrical Stage Employees, Moving picture Technicians, Artists and Allied Crafts of the United States, its Territories and Canada, AFL-CIO-CLC Local Number to represent me for the purpose of collective bargaining with my employer and to negotiate and conclude all agreements respecting wages, hours and other terms and conditions of employment without and election and I herby also apply for membership in the above named Union. Signed Date Social Security Number_ - -

5 Application for Membership in a Local Union of the International Alliance of Theatrical Stage Employees, Moving Picture Technicians, Artists and Allied Crafts of the United States, its Territories and Canada I hereby make application for membership in Local No. of the International Alliance of Theatrical Stage Employees, Moving Picture Technicians, Artists and Allied Crafts of the United States, its Territories and Canada ("the Union"). I base my application for membership on the following facts, which I affirm to be true: I, was born on and presently (Pnnt or Type Name) (Month) (Day) (Year) reside at _ (Street) (City) (State/Province) (Zip/Postal Code) Home Phone Cell Phone Address Do you have a Twitter account? Yes No My Social Security/Insurance Number is I am by occupation a and have worked at the following employers in the entertainment industry: Presently employed by as a (Specify Occupation) Previously applied for membership in a Local Union or Department of the l.a.t.s.e.?, to Local No. Was Application rejected?. This application is for Journeyman or Apprentice? (check one) PLEDGE I, the undersigned, as a condition of my membership in the International Alliance of Theatrical Stage Employees, Moving Picture Technicians, Artists and Allied Crafts of the United States, its Territories and Canada, do solemnly pledge myself to accept and abide by the provisions of the l.a.t.s.e. Constitution and Bylaws, as now in force and hereafter legally amended, hereby express my consent to be governed thereby in the conduct of my trade and in my relationship with the Union. Signature of Applicant Date, 20 Initiation Fee Amount Paid (LOCAL SEAL HERE) This application submitted by Local No. Secretary This is to certify that has on this day of, 20, been admitted to membership in Local No. having fully complied with the requirements as set forth in the Constitution and Bylaws of the Local Union and the International Alliance of Theatrical Stage Employees, Moving Picture Technicians, Artists and Allied Crafts of the United States, its Territories and Canada. Member's Social Security/Insurance Number (LOCAL SEAL HERE) President Secretary THIS STUB TO BE COMPLETED AND RETURNED T O T HE GENERAL OFFICE IMMEDIATELY FOLLOWING APPLICANT'S ADMISSION TO MEMBERSHIP.

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