I, Full Name, NRIC/FIN No:   NRIC No., hereby authorise the Aster Chemicals and Energy Union to represent me in a grievance matter with my current employer,   Company Name   , in respect of my   Form Name   dated   Date. I fully understand that this is my personal decision and I will not hold the union responsible for any consequence arising out of this decision.

I agree to accept any outcome the Union has negotiated on my behalf as full and final settlement of this matter.