CUPE Local 4600 Strike Pay Application Form E

Picket Duty Sign-up Form

*First Name

*Last Name

CUPE Union Number

Unit

*Mobile Number

Numbers only. No dashes or dots.

*Personal Email

We advise against using your utoronto email because it is the property of the employer.

*Street Address

Address Line 2

City

Province

*Postal Code

Work Location

Usual Work Location (building or workplace)

Picket Shift Preference

Picket shifts are four hours long and run from Monday to Friday. We cannot guarantee your shift time, but you can select your preferences below.

First Choice

Second Choice

I am seeking an accommodation

Mark “Yes” if you are seeking an accommodation for modified duties or alternative shift times. Your local will contact you for specifics and any accommodations will have to be approved by CUPE National.

Picket Captain

We are in need of more members to sign up as picket captains. Select "Yes" if you are interested. You will be provided training and support.

Picket Duty Sign-up

Picket Duty Sign-up (CUPE Form E) Sign with your finger (or your cursor) in the box below.

Picket Duty Signature

Sign with your finger in the box.