Please PRINT clearly. Don't forget to sign and and date the card in your own handwriting. Thank you for supporting the AMFA's effort to advance the interests of our profession.

AUTHORIZATION FOR REPRESENTATION UNDER THE RAILWAY LABOR ACT

I authorize the Aircraft Mechanics Fraternal Association to request the National Mediation Board to conduct an investigation and a representation election and upon winning to represent me as my agent in accordance with the terms and provisions of the Railway Labor Act, as amended.

MY RIGHT TO SIGN THIS CARD IS PROTECTED BY FEDERAL LAW

NAME:___________________________________________________________________

AIRLINE:____________ EMPLOYEE NUMBER:_________________________________

JOB TITLE:________________SENIORITY DATE:____/____/____ STATION:__________

DEPT:________________________ SHIFT:_______________ CREW NO:_____________

HOME ADDRESS:__________________________________________________________

CITY:________________________________ STATE:_____________ ZIP:_____________

HOME TELEPHONE: (________)________ - ____________

EMAIL : __________________________________________________________________

DATE: ____/____/____ SIGNATURE: __________________________________________

IMPORTANT: The National Mediation Board requires the Date and Signature to be in your own handwriting.