Duke Researchers United - UAW Authorization Card

Duke Researchers United - UAW Authorization Card
Name

First NameLast Name
Department
If "Other", provide Department here
Email (non-Duke preferred)
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Employer
Start Date at Duke
MM/YYYY
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Job Title
Lab/Research Group
Building
If "Other", provide Building here
Office/Lab Room #
Are you funded by an individual fellowship or training grant (e.g. NIH, NSF, American Heart Assocition)?
If "Yes", which grant?
If "Yes", how is your pay distributed?
I hereby join with my co-workers to improve our wages, our working conditions, and our lives. I authorize Duke Researchers United, United Automobile, Aerospace and Agricultural Implement Workers of America (DRU-UAW) to represent me in collective bargaining. I understand that I will not pay dues or fees until a contract has been democratically approved by Duke postdoctoral researchers.
Signature
Type your full name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
What matters most to you as a researcher at Duke?

As part of the union, I would like to negotiate a contract with Duke that (check all that apply):
Other
If "Other", provide more detail here
Should be Empty:

What matters most to you as a researcher at Duke?