IBEW LOCAL 551

Benevolent Fund Request

BENEVOLENT FUND REQUEST FORM If you find yourself in financially troubled times, please remember that Local 551 has a Benevolent Fund which is available to members in their time of need. Please fill out the form below to make a request to the Benevolent Fund Committee. You can also make contributions to the Fund to help your fellow brothers or sisters.

First Name:	*
Last Name:	*
Address:
City, State:	,
Postal Code:	- *

Phone:
E-Mail Address:	*
Classification:	*
BENEVOLENT FUND REQUEST Please fill out the fields below Please provide us with an explanation of the request and be as specfic as possible *We cannot write out checks personally to you, unless you have documentation of the payment you have made to the person or company

Payable to (Company or Person):	*
Dollar Amount:	*
Explanation for request:	* You can write up to 1000 letters
	* Required Fields