Union Organizing

Name of Company:

Division of:

Company Address:

City:

State:

ZIP:

Personal Information

Contact Name:

Address:

City:

State:

ZIP:

Home Phone:

Cell:

Email:

Best time to reach:

Company Information

No of Employees:

No of Temps:

Wages:

Shift Times:

Customer(s):

Demographic Breakdown (%):

Men: Women:

Products manufactured or services performed:

Is this an Office-Clerical or Technical Unit?
Yes No

Is this a multi-plant operation?
Yes No
If yes, list locations:

Are other facilities of the company organized by the UAW?
Yes No
If yes, list facilities:

Are other facilities of this company organized by other unions?
Yes No
If yes, list facilities:

Is any other union involved at this location?
Yes No
If yes, list other unions:

Any previous attempts made to organize this facility?
Yes No
If yes, list and include approx time frame:

What are the issues?

*DO NOT TALK TO ANYONE ABOUT FORMING YOUR UNION

Oganizing