Authorization for Representation

I hereby authorize Union Local 338 RWDSU/UFCW to represent me for the purpose of collective bargaining.

First Name(*)

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Last Name(*)

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Phone Number(*)

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Email(*)

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Address(*)

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City(*)

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State(*)

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Zip Code(*)

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Company's Name(*)

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Please select which of the following best applies to you(*)

Day Shift Full-Time

Night Shift Full-Time

Day Shift Part-Time

Night Shift Part-Time

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Would you participate in an organizing committee?(*)

Yes

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Store's Address(*)

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City(*)

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State(*)

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Zip Code(*)

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Job Title(*)

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Rate of Pay ($/hr)(*)

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Hourly or Salary?(*)

Hourly

Salary

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Weekly Hours

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Weekly / Bi-Weekly Pay

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CAPTCHA(*)

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Authorization for Representation

Contact Local 338 RWDSU/UFCW