(Fill in blanks with the appropriate information and adapt as necessary.)
(NAME OF UNION)
(CITY, STATE, ZIP)
Dear (MEMBER'S NAME):
I have been informed that under the collective bargaining agreement between (THE UNION NAME AND LOCAL #) and (COMPANY NAME), I am being asked to join the union. I am herewith requesting exemption from the above.
It is my sincere religious conviction that I cannot join or financially support an employee's union. This request is not base on any hard feelings toward any individual or to the labor organization. Rather, it is based on principles I have found in God's Word and as taught by my church. The attached letter from my church pastor and my denomination's official position statement will verify this. I am requesting, based on my religious belief, that (NAME OF UNION) make accommodation for my religious observance and practice, as well as belief, as provided for in Title VII of the Civil Rights Act of 1964, and as amended in 1972, and by the EEOC guidelines. These statutory exemptions are reinforced by the National Labor Relations Act (and California Government Code).
In harmony with the provisions stipulated in the above statutes, I will be glad to pay the equivalent of the dues and fees to a mutually agreeable non-labor, non-religious charity. I will submit to you copies of my receipts as proof of payment. I request that this be initiated immediately in lieu of requiring me to become a dues-paying union member or to tender my dues under an agency shop provision. I am not authorizing a checkoff of my dues. To facilitate this request I am submitting a "Labor Union Agreement" to serve as a memorandum of understanding, which I have filled out and signed. The charity may be filled in when we determine this. The form then needs union and employer authorizing signatures with a completed copy returned to me to confirm this exemption. Thank you for granting this request.
(TYPE YOUR NAME AND ADDRESS BELOW YOUR SIGNATURE)