Suspend / Cancel Suspend / Cancel Your membership First Name Last Name Membership No. Customer Ref No. (CRN) Email Address Select one option only: Select one option only: Cancel Suspend Membership Date to take affect Reason Reason No longer working in the trade/industry Retired Unemployed Transferring interstate to work Moving overseas Other If other why? I agree that I will be liable for any union contributions and levies owing up to the date of cancellation of my membership. * I agree that I will be liable for any union contributions and levies owing up to the date of cancellation of my membership. * I agree that I will be liable for any union contributions and levies owing up to the date of cancellation of my membership. I understand and acknowledge that if I put my membership on HOLD, I will not be eligible to receive membership assistance including Legal advice / Workcover support from the CFMEU * I understand and acknowledge that if I put my membership on HOLD, I will not be eligible to receive membership assistance including Legal advice / Workcover support from the CFMEU * I understand and acknowledge that if I put my membership on HOLD, I will not be eligible to receive membership assistance including Legal advice / Workcover support from the CFMEU 14 + 3 = SUBMIT