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Application for SGEU Local 1102 Retirement Gift
Name of Retiree *
Date *
Retiree Home Address *
City *
Postal Code *
Home Phone Number *
Work Phone Number *
Retiree's Workplace & Ministry *
Workplace Address *
Service Start Date *
Service Completion Date *
Years of Service *
Classification & Level *
Is retiree currently an SGEU in-scope employee? *
-- Is retiree currently an SGEU in-scope employee? --
Yes
No
Work History *
Union Activity *
Contact Information
Contact Person *
Home E-Mail Address *
Home Phone Number *
Work Phone Number *
Home Mail Address *
City *
Postal Code *
Workplace Mail Address *