Authorization for Representation

Request edit access

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

By filling out this form, I hereby authorize the International Brotherhood of Teamsters Local 20 to represent me for the purpose of collective bargaining relating to and respecting wages, hours, and other terms and conditions of employment with my current or future employer within the jurisdiction of the Union. I understand this authorization can be used by the Union to obtain recognition without an election. I further understand that no dues or initiation fees are payable by me until a contract is signed.

Email *

First Name *

Last Name *

Home Address *

City *

State *

Zip Code *

Phone *

Phone Type *

Employer *

Employer Location *

Please enter the address of the location where you work

Title/Classification *

Signature (Type your full name) *

Today's Date *

YYYY

BY CHECKING THE BOX BELOW, I ACCEPT THAT MY TYPED SIGNATURE AND THE DATE ABOVE WILL BE USED AS MY DIGITAL SIGNATURE FOR THE PURPOSES OF THIS FORM.

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms