UNITE FOR STRENGTH
I hereby authorize SEIU 1021 to represent me for the purpose of meeting and conferring on wages, hours and other terms and conditions of employment. I understand and agree that this card may be used to establish majority support among the employees in the unit in which I am employed and obtain recognition from my employer without an election and/or to obtain an election.
Your Name:
*
First Name
Last Name
Job Title
example: Case Manager
Employer
example: Felton Institute
Worksite Location
example: 1005 Atlantic Ave, Alameda
Cellphone:
*
YES, sign me up to receive updates by text and automated calls. I understand that SEIU and its locals and affiliates may use automated calling technologies and/or text message me on my cellular phone on a periodic basis. SEIU will never charge for text message alerts. Carrier message and data rates may apply to such alerts. Text STOP to 55000 to stop receiving messages.
Personal Email:
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Today's Date
*
-
Month
-
Day
Year
TODAY'S DATE.
Signature
*
Submit
Should be Empty: