If you, a relative, friend or neighbor want to know more on how to improve your present wages, benefits and working conditions, please fill out the form below. All information will be treated in a confidential manner.



First Name:
Last Name:
Address:
Address:
City:
State: Zip Code:
E-mail Address:
Phone:
Employer:
Work Address:
Work Address:
City:
State: Zip Code:
Number of Employees: Number of Shifts:


To send this form by postal mail or to contact IAM District W-3 by mail please write to:

I.A.M.A.W. District W-3
718 Grand Avenue
Schofield, WI  54476

Or Telephone:
(715) 355-9728

You may print this form and fax to:
(715) 355-9678

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© 2005 IAM District W-3. All rights reserved.