Petition For Recognition By Mutual Consent Form
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2ALASKA LABOR RELATIONS AGENCY
3301 EAGLE STREET, ROOM 208
P. O. BOX 107026
ANCHORAGE, ALASKA 99510-7026
(907) 269-4895 Fax (907) 269-4898
PETITION FOR RECOGNITION
Office use only
BY MUTUAL CONSENT
Case No.
-RC
Date Filed
8 AAC 97.110
INSTRUCTIONS:
File an original and one copy of this form and file a current roster of labor or employee
organization’s officers and representatives and its constitution and by-laws with the Alaska Labor Relations Agency.
1a.
Name of Public Employer
1b.
Telephone Number
Facsimile Number
1c.
Address
(street, city, state, and ZIP code)
1d.
Employer Representative
1e.
Title
2a.
Full name of labor or employee organization including local name and number and full name of national or international labor
organization of which it is an affiliate or constituent unit.
2b.
Address
2c. Telephone Number
(street, city, state, and ZIP code)
Facsimile Number
2d.
Employee Organization Representative
2e.
Title
3.
Description of proposed unit:
a.
Number of members in proposed unit:
b.
Positions included:
(No. 3 continued on Page 2)
c.
Positions excluded:
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