BR&CF Application for Membership
Brotherhood's Relief and Compensation Fund
300 Sterling Parkway, Suite 105, Mechanicsburg, PA 17050
If your application is approved, your membership will be made effective the 1st day of the succeeding month, or upon successful completion of your new-hire probationary period, whichever occurs later.
A dues payment is not required for new membership.
New members receive their first two (2) months of membership at no cost.
The organization shall not be liable for benefits for any occurrence(s) wherein the cause(s) for the discipline assessed is related, in whole or in part, to any incident(s) that occur prior to the effective date of membership.
Personal Information
SSN
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Name
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Address
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Alabama
Alaska
Alberta
Arizona
Arkansas
British Columbia
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland
North Carolina
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Northwest Territories
Nova Scotia
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Quebec
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon Territory
Email
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Cell Number
Home Number
Date of Birth
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November 2011
November 2011
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Gender
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Employment Information
Occupation
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Brakeman
Car Inspector
Clerk
Coach Cleaner
Conductor
Crew Caller
Dining Car / Porter
Electrician / Foremen
Engineer
Hostler
Laborer
Machinist
Official/Union Member
Other
RR Police
Road Machinery Operator
Roundhouse
Sectionman
Signal Maintainer
Switchman
Tower Operator
Train Dispatcher
Yardmaster
Employer
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A. K. Steel Corporation
Alabama & Tennessee River Railway
Alabama Gulf Coast Railroad
Alabama State Docks
Alabama State Docks Terminal Railroad
Alaska Railroad
Alstom
Alton & Southern Railroad
Amtrak
Arcelormittal Railroad
Bay Area Rapid Transit
Belt Railway of Chicago
Bombardier Canada
Bombardier US
Buffalo & Pittsburgh
Burlington Northern Santa Fe Railroad
CF&E (Rail America)
CSX Transportation System
Canadian National (Canada)
Canadian National (USA)
Canadian Pacific (Canada)
Canadian Pacific (USA)
Cando Rail Services
Cape Breton Central Nova Scotia
Central Maine & Quebec Railway
Central Railroad Company of Indiana
Chicago Rail Link
Chicago, Southshore, South Bend
Connecticut Southern Railroad
Conrail
Dakota, Minnesota & Eastern
Dallas Garland & N. E.
Evansville Western Railway
Florida East Coast
Florida Gulf and Atlantic Railroad
GO Transit
Gary Railway Company
Genesee & Wyoming Railroad
Georgia & Florida Railway
Goderich-Exeter RR
Grand Elk Railroad
Grand Trunk Western
Great Western Railway
Herzog Transit Service, Inc
Hudson Bay Railroad
Huron Central Railroad
Illinois & Midland Railroad
Indiana & Ohio Railway
Indiana Harbor Belt
Indiana Railroad
Indiana Southern Railroad
Iowa Interstate
Iowa Missouri Rail Link
Kansas City Southern
Kansas City Terminal
Keolis Railroad
Kia Michi Railroad
Kyle Railroad
Long Island
Louisville & Indiana Railroad
Mass Bay Commuter Railroad
Metra Raiload
Metro North
Metrolink
Mississippi Export Railroad
Missouri North Arkansas R.R.
Montana Rail Link
New England Central Railroad
New Jersey Transit
New Orleans Public Belt
New York and Atlantic Railway
New York, Susquehanna, & Western
Norfolk Southern Corporation
Northern Illinois Railway Corp
Northern Indiana Commuter Transportaion
Ontario Northland
Other
Ottawa Valley Railways
Pacific Harbor Line
Paducah & Louisville
Pan Am Rail
Port Authority Trans-Hudson
Port Terminal RR Assoc
Portland & Western
Portland Terminal RR
Portland Vancouver Junct RR (non-union)
Providence and Worchester Railroad
Que, Northshore $ Labrador
Quebec Cartier Mining RR
Reading & Northern Railroad
Red River Valley & Western RR
South Buffalo Railwary
Southeastern Penna Transit Asn
Springfield Term Railway
Staten Island Rapid Transit
SunRail
Tacoma Municipal Beltline Railroad
Tazewell & Peoria Railroad
Terminal RR Assoc St. Louis
Texas City Terminal Railway Co
Texas Mexican Railway
Texas Pacifico Transortation Ltd.
Toledo Peoria Western
Toronto Terminal Railway
TransED
Transit America Services Inc.
Tri-County Commuter Rail Authority
Union Pacific Railroad
Union Railroad
Utah Railway (Short Line)
VIA/Canadian Passenger
Veolia Transportation Inc
Virginia Railway Express
Washington Metro Area Transit Authority
Wheeling & Lake Erie
Willamette & Pacific Railroad
Wisconsin & Southern Railroad
Wisconsin Central Railroad
Labor Organization(Union)
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Allied Eastern Federation
Amalgamated Transit Union
American Railway Supervisors Assoc.
American Train Dispatchers Association
Armco Employees Independent Federation
Association Commuter Railroad Employees
Brotherhood of Loc. Engineers & Trainmen
Brotherhood of Maintenance of Way Emp.
Brotherhood of Railroad Signalmen
Brotherhood of Railway Carmen of America
Can Div. US Steel Workers
Canadian Auto Workers
Canadian Clerks
Canadian National Railway Police Assoc.
Canadian Operators & Dispatchers
Canadian Railroad Transportation Carmen
Canadian Union for Transportation Employ
Hotel&Restuarant Emp. & Bartenders Int'l
Int'l Brotherhood of Electrical Workers
International Association of Machinists
International Brotherhood of Teamsters
Laborers International Union of North America
Metelos
Metropolitan Alliance of Police
National Conference of Firemen & Oilers
Office and Professional Employees International Union
Other
Service Employees International Union
Sheet Metal Workers International Assoc.
Sheet Metal, Air, Rail & Transportation (SMART-TD)
Teamsters Canada Rail Conference
Transport Workers Union of America
Transportation & Comm. Employees' Union
Transportation Workers of America
UNIFOR – Rail Division
US Steel Workers
United Railway Supervisors Assoc.
United Transportation Union
Date of Hire
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November 2024
November 2024
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Are you on probation as a new hire employee?
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If yes, date to be completed:
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Membership cannot be considered if the new-hire completion date is over 60 days from now. Please reapply within 60 days of completion.
Calendar
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Benefit Level Selection
Dues Payment Authorization
The BR&CF has transitioned to a single method of collecting dues and distributing benefits.
By submission of this application, I authorize BR&CF to debit my membership dues from this account. A monthly deduction missed for any reason will simply be made up by double deduction the following month. In addition, I understand the BR&CF will utilize this account to directly deposit dues refunds, referral fees, and benefit payments.
Debit Date:
Discipline History
Have you had any recent occurrences or incidents for which potential discipline
might still be pending?
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Have you had any occurrences or incidents at any time in your railroad career which resulted in dismissal?
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Have you had any occurrences or incidents within the past five (5) years which were handled under a Discipline Diversion Program or which resulted in any of the following:
Actual Suspension, Deferred Suspension, Record Suspension, Time Served, Demerits, Probation, or Decertification/Revocation of FRA Certificate?
*
CSX - IDPAP
NS - S.T.A.R.T (Minor/ Serious / Major )
UP - M.A.P.S.
ALSO INCLUDE ANY SIMILAR PROGRAMS
Are you currently serving probation due to discipline or due to an occurrence or incident handled under a Discipline Diversion Program?
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CSX - IDPAP
NS - S.T.A.R.T (Minor/ Serious / Major )
UP - M.A.P.S.
ALSO INCLUDE ANY SIMILAR PROGRAMS
Referring Member
Did anyone refer you to the BR&CF?
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Member ID
Name
Beneficiary
A $50,000 accidental death and dismemberment policy while on duty only is provided at no additional cost to members "In Good and Regular Standing". Please provide us with the following information and update as necessary.
Name
Relationship