WHC Payroll Deduction Date *Name: *Signature: *Start signing your signature hereYour browser does not support e-Signature field.Department: *Shift: *Job Title: *Employee #: *Date of Hire: *Date of Birth *Street Address *Apartment, suite, etcCityState/ProvinceZIP / Postal CodeHome Phone Number: *Cell Phone Number: *Email Address: *Work Phone Number: *I hereby authorize WHC to deduct from my wage and pay to Local 722, SEIU, such initiation fee and membership dues in amounts as may be established by the union from time to time in accordance with the union's constitution, by-laws, and applicable laws.Submit
