OPEIU Sample Authorization for Representation

Authorization for Representation
Joining together gives us a voice in making our workplace better for everyone. By completing the form below and clicking "submit," I am authorizing OPEIU Local __ to represent me for the purpose of collective bargaining with my employer, ______________. My right to submit this authorization is protected by Federal law.
Date*

MonthDayYear
Date
Name*

First NameLast Name
Cell / Home Phone*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Apt#
Email*
example@example.com
Job Title*
Dept / Unit
Signature*

Clear
Union Organizing Committee

Yes, I'd like to be part of the Union Organizing Committee.
Should be Empty: