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Authorization for Representation

I authorize the International Brotherhood of Electrical Workers to represent me as my exclusive bargaining representative for wages, hours and other terms and conditions of employment.  I understand that if over 50% of the employees in my classification sign an authorization card, an election may not be necessary for me to be represented by the Union.

ALL INFORMATION IS STRICTLY CONFIDENTIAL AND NEVER SHARED WITH THE EMPLOYER


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First Name *
Last Name *
Phone Number *
Personal e-mail address *
Home Address *
Home City *
Home State *
Home Zip *
Mailing Address (If different from Home)
Mailing City (If different from Home)
Mailing State (If different from Home)
Mailing Zip (If different from Home)
Company *
Department *
Title *
Company Address *
Company City *
Company State *
Company Zip *
Signature *

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Acknowledgement Check Box *
By submitting this form, I acknowledge and understand that I am authorizing the International Brotherhood of Electrical Workers to represent me as my exclusive bargaining representative for wages, hours and other terms and conditions of employment. I understand that if over 50% of the employees in my classification sign an authorization card, an election may not be necessary for me to be represented by the Union. This Authorization is nonexpiring binding and valid until such time as I submit a written revocation.

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