INSTRUCTIONS: Please fill in information displayed below

Each member is required to serve at least two four hour shifts (total 8hrs per week).
Should you choose the midnight shift, picket duty will be one eight hour shift which will satisfy your requirements per week.

Full Name
Employee Number
Address
Work Location
Department
Email Address
Contact Phone Number
Business Phone Number
Name of Shop Steward
Picket Duty Location
*** PLEASE MARK BELOW YOUR CHOICE OF SERVICE FOR EACH WEEK ***
8 am to 12pm	S M T W T F S
12 pm to 4pm	S M T W T F S
4 pm to 8pm	S M T W T F S
8 pm to mid	S M T W T F S
Mid to 8 am	S M T W T F S

For Information regarding scholarship click here.

For Information regarding WTC injuries click here.

For Election Results, please visit our news page.

Please help Local 1-2 provide Christmas at Rosary Hill, for more information, click here.

If you are injured click here.

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