Daily Report Template - Canadian Union Of Public Employees

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F
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Daily Report –
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Picket Captain’s or Strike Benefits
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Committee Chairperson
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Print!as!many!copies!of!this!blank!form!as!needed.!
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Local!Union!No.:!_____________________________________________________________________!
Shift!covered!(date,!time):!_______________________________________________________________!
Date!of!report!completion:!!______________________________________________________________!
Location!(picket!line,!headquarter,!etc.):!____________________________________________________!
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Type(of(picket(duty(or(other(
Signature(
Time(in(
Time(out(
assigned(duties(
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Information!above!is!accurate!and!verified,!signed!this!___________of_________________,!20________!
Chairperson,(strike(benefits(committee:!_________________________________________________!
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(print(and(signature)
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:!_____________________________________________________________
Picket(Captain’s(signature
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(print(and(signature)
National(Strike(Fund(0(Form(“F”
(
Revised(September(2015(
:nf/cope(491(

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