Only local union business managers are authorized to complete and submit the Local Union Political Coordinator Information Form.

Example: John Iron
Example: 123456

Local Union Political Coordinator Contact Information Form

Please do not use all caps. Example: Maryland
Please use all numbers. Example: 654321
Please do not use all caps. Example: Smith
Please do not use all caps. Example: John
Example: 1/15/1962
Title





Please do not use all caps. Example: 123 Main St.
Please do not use all caps. Example: Anycity
Please do not use all caps. Example: Maryland
Please use five digit zip.
Example: 123-456-7890
Example: 123-456-7890
Example: 123-456-7890
Example: jsmith@yahooaol.com

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