Please submit the form bellow to take part in the dispute regarding Annual Leave Accrual at the Barker Inlet Power Station Site.

Primero Annual Leave Dispute
Are you a CEPU/ETU Member *

Your Details

Day / Month / Year
Street Address
Street Address Line 2
Suburb
Post Code
Street Address
Street Address Line 2
Suburb
Post Code

Employment

Commencement Date: Day / Month / Year
Completion Date: Day / Month / Year
Home Phone
Mobile Phone
Personal Email
Work Email
Business Name
Work Location/Site
Department

Membership

Contracting Industries (CI) Levy Acknowledgement

I acknowledge that: *

Payment Method

Direct Debit – Credit Card (Recurring)

For security reasons please phone 08 8234 2130 or visit our office to provide Credit Card payment details / OR / Submit the form and we will call you to process a Credit Card payment.

Direct Debit – Bank Account (Recurring)

Employer *
Are you still employed at BIPS? *
Did you work any night shift during your employment at BIPS? *
Did you take any annual leave during your employment at BIPS? *
Would you agree to provide the CEPU a witness statement for proceedings in either the Fair Work Commission or the South Australian Employment Tribuneral? *
Would you give the CEPU permission to act on your behalf in relation to this matter, if it meant revealing your union membership to your employer? *