UFCW Local 1500 Digital Authorization Form

By filling the following form I am authorizing United Food and Commercial Workers (UFCW) Local 1500 to be my voice on the job and to represent me to obtain better wages, benefits and working conditions.

Quiero que la UFCW Local 1500 sea mi voz en el trabajo y me represente para obtener mejores salarios, beneficios y condiciones de trabajo.

Name(Required)

First Last

Phone Number(Required)

Email Address(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Please check the box if you agree to have UFCW Local 1500 represent you at your workplace(Required)

I authorize UFCW Local 1500 to represent me

Digital Signature(Required)

Please type your name as a digital signature for this authorization form

Employer Name & Location(Required)

We will never share your information with your employer, your information is confidential

What is 2+2?(Required)

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Digital Authorization

UFCW Local 1500

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