Application for
Fraternal Membership

Proposed Member Information

* Required Field


* First Name:
Middle Initial:
* Last Name:
* Street Address:
* City:
* State/Prov.:
* Zip/Postal Code:
* Country:
* Phone: () -
* Date of Birth: M/D/Y
* E-mail:


If you know the council you wish to join, enter the council number:

Please read the TERMS AND CONDITIONS:
Please enroll me for membership in The Order of United Commercial Travelers of America (UCT). I understand UCT is a fraternal benefit society, and I agree to abide by the Society's Constitution and Bylaws.

I have read and agree to the TERMS AND CONDITIONS