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 165 by mail please write to:
 

Main Office
1903 4th Street North
St. Cloud, MN 56303

Or Telephone
Phone: 1.320.252.4654 or
1.800.258.3735

Or Fax
320.252.4659