Siemens Workers United Authorization Form | campaign.boilermakers.org

SIEMENS WORKERS UNITED SACRAMENTO CA SIEMENS MOBILITY INC

Authorization for Representation

This card is strictly confidential.

First Name ^*

Last Name ^*

Address ^*

Address Line 2

City ^*

State ^*

Zipcode ^*

Phone ^*

Email ^*

Date of Hire ^*

Month

Day

Year

Department ^*

Classification

Shift

Yes, I would like to receive emails and/or text messages* with updates from the Boilermakers. *Standard message rates will apply. You may unsubscribe at any time.

Authorization for Representation ^*

I hereby authorize the International Brotherhood of Boilermakers and its designated Local Lodge, and Local Union No. 1245 of the International Brotherhood of Electrical Workers to represent me in collective bargaining for better wages, hours and working conditions with my employer. This card maybe used to secure Union recognition.

Signature ^*

I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law.

Signature Form ^*

Signature Form