Change of Address

Please fill out the form below:

First Name *

Last Name *

Employee Number Please enter your 6-digit Employee Number.

Local *

Personal Email Address *

Previous Address *

Address 1 *

Address 2

City *

State *

ZIP code *

New Address

Country

Address 1 *

Address 2

City *

State *

ZIP code *

Authorization

I hereby authorize a change of address as set forth above.  By signing and submitting this form I am confirming that I am the person whose name appears herein and that the information entered is accurate.

Signature

RI Council 94 AFSCME AFL-CIO

Change of Address

Change of Address