Authorization for Representation

I hereby authorize United Food & Commercial Workers Local 400 to represent me for the purpose of collective bargaining.

Name*
First Last
Home Phone
Mobile Phone*
Email*
Home Address*
Street Address Address Line 2 City State ZIP Code
Name of Employer*
Workplace Address*
Street Address Address Line 2 City State ZIP Code
Communication Consent*
Agree
By providing a cell phone number and email address, I agree that UFCW Local 400 and the UFCW International Union can send me auto-dialed calls, texts, emails, and other communications. I reserve the right to opt out. Carrier and message rates may apply.