Please print this page, complete the card and mail to:

UFCW Local 1428
P.O. Box 9000
705 W. Arrow Hwy.
Claremont, CA. 91711-9000

THIS INFORMATION IS NOT FOR NEW EMPLOYEES OF STORES THAT ARE ALREADY UNIONIZED BY LOCAL 1428, SUCH AS VONS, RALPHS, STATER BROTHERS, ALBERTSON'S, OR RITE AID.