California Alternative Workweek Secret Ballot Election Forms

Form Option 1:

Voting on a single proposed alternative workweek schedule

ELECTION DATE: _________ CENTER: _______________

By this secret ballot, I am voluntarily voting on whether to formally adopt a regular alternative workweek schedule of [four days per week at 10 hours per day], as described by [Company Name]’s Proposal. I understand that if this schedule is adopted by 2/3 of the affected employees, I will not receive overtime wages for the [ninth and 10^th] hours of work on the regularly scheduled [10-hour] days.

□ Yes, I agree to adopt the [4-day/10-hour] schedule.

□ No, I do not agree to adopt the [4-day/10-hour] schedule.

Form Option 2:

Voting on a proposed menu of alternative workweek schedules, including a regular 5/8 schedule

ELECTION DATE: _________ CENTER: _______________

By this secret ballot, I am voluntarily voting on whether to formally adopt the following menu of work schedule options for each week, as described by [Company Name]’s Proposal:

Schedule 1:

4 day/10-hour schedule: Four 10-hour days per week; no overtime wages for the ninth and 10^th hours of work on the regularly scheduled 10-hour days.

Schedule 2:

3 day/12-hour + 1 day/4-hour schedule: Three 12-hour days and one four-hour day per week; no overtime wages for the ninth, 10^th, 11^th and 12^th hours of work on the regularly scheduled 12-hour days.

Schedule 3:

5 day/8-hour schedule: Five eight-hour days per week.

□ Yes, I agree to adopt the above menu of work schedule options.

□ No, I do not agree to adopt the above menu of work schedule options.