Strike Declaration Form
Use this form to formally declare your participation in an organized strike. Please provide all required information accurately.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Job Title/Position
*
Department/Unit
Employer/Organization Name
*
Union Affiliation
*
Please Select
Yes, I am a union member
No, I am not a union member
Prefer not to say
Strike Start Date
*
-
Month
-
Day
Year
Date
Expected Duration of Strike
*
Please Select
1 day
2-3 days
1 week
Indefinite/Until demands are met
Other
Reason for Participating in the Strike
*
Additional Comments (optional)
Signature (Please sign below to confirm your declaration)
*
Submit Declaration
Submit Declaration
Should be Empty: