This form will close on May 15 at 5pm
Pay dates:
Week 1 is Mar. 8
Week 2 is Mar. 15
Week 3 is Mar. 22
Week 4 is Mar. 28
Week 5 is Apr. 5
Week 6 is Apr. 12
Week 7 is Apr. 19
Week 8 is Apr. 26
On the next page(s), please tell us ALL of the shift(s) you have picketed for the week. Note that members will be paid out for only 20 hours/5 shifts, so there is room to indicate up to 5 shifts.