Authorization For Representation

AUTHORIZATION FOR RESPRESENTATION

I, the undersigned employee of (company name below) designate and authorize the Southern California District Council of Laborers and its affiliated local unions, AFL-CIO, to act as my collective bargaining representative with my Employer. This authorization is signed by me for the purpose of securing, for the Union, voluntary recognition and negotiation rights with my Employer and with any future employer. It may be revoked only by me, through written notice to the Union.

Company Name
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Signature
Date
MM slash DD slash YYYY