1095 Steward Application

LiUNA 1095 - Steward Application
Laborers' International Union of North America

Local Union Constitution

Article VI E -BUSINESS MANAGER (Pg. 85) (3) The Business Manager shall have the authority to appoint, remove, and supervise Stewards.
Name*
Member No.*
Address*

Street Address

Street Address Line 2

CityState

Zip
Phone*
Date of Birth*

MonthDayYear
Date
Email*
Current Employer
Postion
Location
Years with Employer
QUESTIONNAIRE
Are you Current on your Union Dues?*

YesNo
How Long have you been a LiUNA member?*
Are you able to read, write, and understand basic English?*

YesNo
Are you capable of communicating in a clear effective professional manner?*

YesNo
Are you currently working at a job in which you exercise any of the following functions? (Please check all that apply, if any)

You are able to hire, fire, suspend or transfer other employees.You have the ability to assign work within the company and direct the performance of that work.You are able to promote, reward, or discipline employeesYou have the ability to adjust grievances of employeesYou seek out and negotiate work for the Employer.
Are you paid by the Hour or a Salaried employee?*

HourlySalary
Are you able to assist coworkers in an unbiased manner (no favoritism)?*

YesNo
Are you willing to help coworkers regardless of their color, religion, sex, ethnicity, language, gender, or any other distinguishing characteristic?*

YesNo
Are you willing to study the Collective Bargaining Agreement, participate in available training, and work with the local union to resolve issues and improve the work place?*

YesNo
Why do you want to be a steward?
What do you want to accomplish as a steward?
I understand that the position of a steward is being the eyes, ears, and by extension, a representative of the Local 1095 Business Manager, and that my professionalism in all Union matters is important so I can properly represent my brothers & sisters (i.e. coworkers) and strive to resolve disputes. By signing below I acknowledge the expectations and agree to do my best to uphold the Collective Bargaining Agreement and protect the members. Furthermore, I understand that submitting an application does not contitute an appointment as steward.
Signature*

Please electronically sign this application Clear
Date

MonthDayYear
Date
Interview date

MonthDayYear
Date
Approved
Not Aproved
Notes
Business Manager
Date

MonthDayYear
Date
Should be Empty:

LiUNA 1095 - Steward Application

QUESTIONNAIRE