ORGANIZING LEAD

(PLEASE PRINT OR TYPE)

NAME: ____________________________________________________________

ADDRESS:_________________________________________________________

                   _________________________________________________________

CITY: _____________________________ STATE: ________ZIP:_____________

PHONE: ( ______ ) _______ - _____________

BEST TIME TO CONTACT___________________________________________

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EMPLOYER:________________________________________________________

ADDRESS: _________________________________________________________

CITY: _____________________________ STATE: _______ ZIP:______________

NUMBER OF EMPLOYEES: __________ NUMBER OF SHIFTS: __________

USE BACK SIDE FOR ADDITIONAL COMMENTS.

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PRINT USING YOUR SYSTEMS PRINT FUNCTION AND FILL IN:

To send this form by postal mail or to contact IAM District 10 by mail please write to:
 

Main Office
1650 South 38th Street
Milwaukee, WI
53215-1726

Or Telephone
414-643-4334

You may print this form and fax it to:
FAX 414 643-4715