Representation Authorization Form
Communications Workers of America AFL/CIO

Step 1 - Your Information (*required field)

Type information in fields provided:

 

First Name:*
Last Name:*
Home E-mail:*
Street:*
City:*
State:*
Zip:*
Home Phone:*
Job Title:*
Job Location:*
 IBM Site:* (i.e., Burlington, Fishkill)
IBM Building:* (i.e., number, name)

Union Representation Authorization

I am an employee of IBM and I hereby designate the Communications Workers of America as my collective bargaining representative.

(required) Signature: ___________________________

(required) Date:_____________

This authorization form is Union confidential. IBM will not see it.

Step 2 - Print and Mail or Fax this form to:

Alliance@IBM/CWA Local 1701
435 Main Street
Johnson City, NY 13790

Phone: (607) 729-4671 Fax (607) 797-1239