Interest Card Form

Name *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Job Title *

Phone *

Email *

Employer *

Work Location *

Signature *

Please type name here

Date / Time *

I hereby authorize the International Union, Security, Police & Fire Professionals of America, (SPFPA) to represent me for the purposes of collective bargaining with the above Employer and all successors and/or assigns to improve wages, benefits and working conditions. *

Please check box to authorize

By clicking the submit button below, I affirm that I am an employee of the employer named in the contact form and I want to be represented for the purposes of collective bargaining by the International Union, Security, Police and Fire Professionals of America (SPFPA).

Name