UNITED FOOD & COMMERCIAL WORKERS UNION
LOCAL 791
AUTHORIZATION FOR REPRESENTATION

 

I hereby authorize the United Food and Commercial Workers Union, Local 791
to represent me for the purposes of collective bargaining.

 

 

_________________________________________________________
PRINT NAME                                SOCIAL SECURITY # OR SSI

_________________________________________________________
SIGNATURE                               DATE

_______________________________________________________________________
HOME ADDRESS                                                  CITY                 STATE        ZIP

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E-MAIL ADDRESS                                HOME PHONE

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EMPLOYER'S NAME                                EMPLOYER'S ADDRESS

_________________________________________________________
HIRE DATE              TYPE OF WORK PERFORMED                  DEPARTMENT

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HOURLY RATE         DAY OFF         SHIFT/HOURS        FULL-TIME PART-TIME (CIRCLE ONE)

WOULD YOU PARTICIPATE IN AN ORGANIZING COMMITTEE? YES NO (CIRCLE ONE)

 

UFCW Local 791, 55 Norfolk Ave., South Easton, MA 02375
1-800 535-2752

 

 

 

 
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