LaborChart Authorization to Send & Receive Messages



NAME (Please Print): ___________________________


Text Messages

By signing this form, I authorize [COMPANY NAME] to send text messages to my cell phone to convey work assignments and other important information. I understand that standard text messaging, data and phone rates may apply to any messages received from [COMPANY NAME] or sent to [COMPANY NAME], and that [COMPANY NAME] is not responsible for payment of those fees. I also understand that I or [COMPANY NAME] may revoke this permission at any time. 


I agree that in the event my cell phone number and/or cell phone provider changes, I will inform [COMPANY NAME].


▢ I DECLINE and DO NOT want to receive text messages at this time.

▢ I ACCEPT and DO want to receive text messages.


Cell Phone #: _____________________________


Cell Phone Provider: ________________________

                                (Verizon, AT&T, T-Mobile, etc.)


Email Messages

By signing this form, I authorize [COMPANY NAME] to send emails to me to convey work assignments and other important company information. I also understand that I or [COMPANY NAME] may revoke this permission at any time.


In the event my email address changes, I will inform [COMPANY NAME].


▢ I DECLINE and DO NOT want to receive emails at this time.

▢ I ACCEPT and DO want to receive emails.


Email Address: ______________________________




This authorization will remain in effect until revoked in writing by me or [COMPANY NAME].




Signature:________________________________            Date:___________________


Privacy Disclaimer: This text message and email program is provided as a service to workers to give important information in a timely manner. Your information will not be sold or distributed in any way.