UFCW Local 135

Forms

PERSONAL INFO CHANGE FORM

     
    Leave blank if no changes

    Withdraw/Return Form

      Withdrawal or Return to Work
      Reason for Withdrawal
      (Must be out at least one full calendar month for LOA)

      Vacation Waiver Form

        Insurance Forms Request

        Important: To enroll in healthcare, you must call our insurance office at (619)298-7772 ext. 8. The forms below are for currently enrolled members.

          What form(s) are you requesting?*
          Check all that apply.

          Volunteer Form

            What type of volunteering are you interested in?*
            Check all that apply.