CHANGE OF ADDRESS FORM

NOTE: Your employer does not provide us with your change of name, address, or phone information.
(If you've been promoted out of your bargaining unit, please check
your employee packet for the correct procedure to follow to notify us.)

Please take a moment to update your new information, so we can stay in touch with you.

 

First and Last Name Address City Zip Code Area Code/Telephone Home  Work Cell Phone or Pager Workplace: Agency/Department Email Address Member Number Click on the Send button below to email your completed form to Local 777.     Or, you can also print this form and fax it or mail it to:   Attention: Diana Diaz (951) 682-4592 (fax) Attention: Diana Diaz LIUNA, Local 777 4000 Tenth Street Riverside, CA 92501

Copyright 2003 - LIUNA Local 777 - All Rights Reserved