Withdrawal Card Request – UFCW Local1500

Need a withdrawal card? Simple! Just fill out the form below or send an email to wcards@ufcw1500.org with your name, last date you worked, and a message stating you are requesting a withdrawal card, and we’ll let you know when we send it out to you!

Withdrawal Card Request Form

First Name(Required)

Last Name(Required)

Phone Number

Email Address(Required)

Member ID#

Your UFCW Member ID# (OK if you don't have it handy)

Company(Required)

The company you work for

Store #

Last Date You Worked:(Required)

Please type the month, date and year

Address 1

Address 2

City

Zip

State

Request(Required)

Please state you are requesting a withdrawal card from UFCW Local 1500

Please check the box to authorize your request of a Withdrawal Card(Required)

By checking this box I hereby acknowledge and state that I am requesting a Withdrawal Card from United Food and Commercial Workers Local 1500

Withdrawal Card Request Form

Withdrawal Card Request Form

UFCW Local 1500

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