Board Of Aldermen - Agenda - 1/2/2020 - P93

APPENDIX #A:

FILL BOXES MARKED WITH AN (X)

REQUEST AND AUTHORIZATION FOR VOLUNTRY ALLOTMENT OF COMPENSATION
FOR PAYMENT OF EMPLOYEE ORGANIZATION DUES AND REQUEST THE UNITED
FEDERATION OF POLICE OFFICERS’ TO ACT AS MY EXCLUSIVE COLLECTIVE
BARGAINING AGENT

NAME OF EMPLOYEE (Print Last Name, First, Middle) INDENTIFICATION NO. (Sac. Sec. or Other)

(x) (X)

HOME ADDRESS (Street and Number) CITY AND STATE ZIP CODE

(X) (X)

PHONE DEPARTMENT

(X), (X)_Nashua Police Department Professional Employees

NAME OF EMPLOYEE ORGANIZATION

UNITED FEDERATION OF POLICE OFFICERS’ LOCAL

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