UUP Binghamton Chapter - Department Rep Contact Info Form

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During contract negotiations it is important that we are able to provide updated important information to our members. We are asking all members to provide a personal email and cell phone so we can stay connected with you. No information will be shared with anyone or any other sources.

First Name *

Last Name *

Department Rep *

I am interested in being a Department Rep

Yes

Maybe (need more information)

Department *

Personal Email Address *

Please do not enter your binghamton.edu email address.

Personal Phone Number *

Mobile preferred.

Text Alerts *

I would like to receive text alerts

Yes

Submit

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