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Questions marked with a * are required Exit Survey
 
Contact Information
First Name : 
Last Name (include Sr.,Jr, III) : 
Address Line 1 : 
Address Line 2 : 
City : 
State : 
Zipcode : 
Phone : 
Home Email Address : 
 
 
 
Identify Your Union Title (Member or Local Lodge Officer, District Council Delegate, District Council Alternate, Business Rep, Staff etc.)
   
 
 
 
Gender
   
 
 
 
Years Served in the Military
   
 
 
 
In which branch and/or branches have you served? Check all that apply
 
Air Force
 
Army
 
Coast Guard
 
Marine Corps
 
Navy
 
National Guard
 
Reserve
 
Other
 

 
 
 
Current IAMAW Status ( Active or Retired)
   
 
 
 
BEMSID Number or if non-Boeing, the last four of your SSN# 
   
 
 
 
Willing to serve on a veteran service committee?
 
YES
 
NO
 
 
 
What Local Lodge are you?
(I.e. [Machinists, Toolmakers, Facilities Maintenance are in Local C]
[Assembly mechanics, forklift, crane operators, factory service are in Local A]
[QA, Expedite, tool room clerks are in Local F]
[Avionic technicians are in Local E]
 
Local A
 
Local C
 
Local E
 
Local F
 
Eastern WA Local 1951
 
Eastern WA Local 1123
 
Eastern WA Local 86
 
Other
 
 
 
 
* Tee Shirt Size?