Below is an authorization for representation card. You can now fill this out by printing it at home, in the privacy of your home and mailing it to

Teamsters Local 325

5533 11th Street

Rockford, Illinois 61109

Teamsters Local Union No. 325

Affiliated with the Internaional Brotherhood of Teamsters

Authorization for Representation

I, the undersigned, freely and voluntarily designate Teamsters Local Union No.325 as my exclusive Bargaining Agent for the purpose of Collective Bargaining concerning Rate of Pay,Hours, Terms and Conditions of employment and the adjustment of grievances with my employer.

Printed Name:____________________________________________

Signature:_______________________________________________

Address:________________________________________________

City:_____________________STATE:_________________________

Phone No.______________________________DATE:_____________

Employer:_______________________________________________

Email Optional____________________________________________