I hearby authorize the International Union of Operating Engineers Local No. 101 to represent me for the purpose of collective bargaining in matters of wages, hours, and other conditions of employement, with my current employer, as well as all other employers for whom I may become employed after this date, on all present and future jobsites. This authorization is non-expiring, binding, and valid until I submit a written revocation. I understand that this card may be used to obtain recognition from my current or future employer without an election.

By checking this box, I accept that my typed name, manual signature, and date will be used as my digital signature for the purposes of this form.*