Registration Form

Designation Of Collective Bargaining Representative and Application for Membership

I am a TLC driver, primarily employed by*

and I hereby designate and authorize the above-named Union to act for me as my collective bargaining agent in all matters pertaining to wages, hours, and other terms and conditions of employment; and I hereby also apply for membership in the above-named Union.

Name*

First Last

Date*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email*

Enter Email Confirm Email

Location*

Phone/Cell#*

*

By checking this box, I agree to receive future communications, including SMS text messages from Local 1181-1061, Amalgamated Transit Union, AFL-CIO

By clicking the submit button below, I affirm that I am authorizing Local 1181-1061, Amalgamated Transit Union, AFL-CIO to act for me as my collective bargaining agent in all matters pertaining to wages, and other terms and conditions of employment.

Uber and Other TLC Driver Form

Uber and Other TLC Driver Form