IP-35 Lost Timer Signup | UFCW555 Internal

IP-35 Lost-Timer Signup

Fill out this form in order to sign up as a "lost-timer" working on the IP-35 signature-gathering campaign. This information will be shared with third-party contractor Fieldworks as needed.

Personal Information

First Name

Last Name

Worksite (Where you work now)

Email Address

Best Phone Number

Understanding (You must read and check these boxes before signing up.)

I understand that as a lost-timer, I will be paid by UFCW Local 555, and then return to my usual worksite likely before July 1, 2024.

I understand that Fieldworks will be supervising my training and day-to-day work activities and advising UFCW Local 555 as to any personnel matters.

I understand that the State of Oregon will not allow me to perform this work if I have a conviction for fraud, identity theft, or forgery on my record, and I understand that UFCW Local 555 or Fieldworks may perform a State-required background check to confirm this.

I understand that it is my responsibility to inform my employer that I will be taking this time to perform work for UFCW Local 555. My rep can help me with this.

I understand that I will have to read the Oregon Circulator Training Manual as part of my State-required training. I understand that I can download a PDF of the manual at the link below.

Download Circulator Training Manual (PDF)

Forms

You will need to provide a 2024 W-4 tax form to UFCW Local 555 if you have not already done so in 2024. You may upload it here or deliver it to UFCW Local 555, but the Local must have it in hand before you are paid.

Generate your W4 online

or

Download a blank Form W-4 (PDF)

If you generate your form online, you will still need to upload the PDF you downloaded.

The online form does not include the optional Page 3 worksheet. See instructions here.

Upload Form W-4

If you have not already been a lost-timer in 2024, you will also need to provide an I-9 form, along with proof of eligibility to work (typically a Social Security Card or U.S. Birth Certificate) and your identity (typically a Driver License) or both (typically a U.S. Passport.) By law, we are not permitted to accept these remotely. You must bring valid identification (usually a Driver License) and proof of eligibility to work (usually a Social Security card or birth certificate) or an ID that fulfills both (usually a U.S. Passport) to your onboarding appointment. If you worked for UFCW 555 as a lost-timer already in 2024, we already have an I-9 for you and you do not need to do this again!

Download a blank Form I-9 (PDF)

You can also fill out a Direct Deposit form. It is optional, but highly recommended. Instead of uploading this, download it and then email it directly to mswan@ufcw555.org.

Generate your Direct Deposit form online

Onboarding Appointment

Select from the available times and locations below to schedule your onboarding and training with Fieldworks.

Confirm!

If all of the information is correct, press SUBMIT to be scheduled for the onboarding appointment you selected. A confirmation e-mail will be sent to your email address and Fieldworks will be informed that you will be attending the appointment you selected.

An error occurred. Try again later

Congratulations! You have been signed up. A confirmation email will be sent to _. As a reminder, you will be attending the following onboarding appointment: _