Industrial Assistance Form

First name *

Last name *

Member Number *

Profession / Role

Phone *

Email *

Mobile

Preferred contact method *

Employer *

Worksite *

Employment

Supervisor

Supervisor's Phone

Local Workplace Delegate

Local Workplace Delegate's Number

Principle Elements of Issue *

Resolution Sought *

Have you got an urgent meeting date/deadline about this issue? If so when?

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I have read the Union’s Industrial Assistance Policy

1800 177 244

members@together.org.au