Authorization Card – UFCW Local 888

First Name *

MI

Last Name *

Email *

Cell Phone *

Home Phone

Address *

Apt. #

City *

State *

Zip Code *

Would you participate in an organizing committee? *

Employer Name *

Employer Address

Hire Date *

Type of Work Performed

Department or Job Classification

Hourly Wage / Rate

Work Shift *

Employment Type *

Authorization for Representation *

I hereby authorize Local 888 UFCW to represent me for the purpose of collective bargaining.

Signature *

Clear Signature

Draw signature with your finger or mouse.

Date Signed *