Leadsheet

PRINT USING YOUR SYSTEMS PRINT FUNCTION AND FILL IN:

(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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To send this form by postal mail or fax to IAM Local Lodge 778:

IAM Lodge 778

9404 Grandview Rd.

Kansas City, MO 64132

FAX: 816-363-7163