CWA Local 3176

COMMUNICATIONS WORKERS OF AMERICA

LOCAL 3176

Lumen Transfer Request Form

DATE OF REQUEST *

CONTACT INFORMATION

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FIRST NAME *

LAST NAME *

SAP ID *

COMPANY EMAIL *

COMPANY CELLPHONE *

SENIORITY INFORMATION

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ORIGINAL HIRE DATE

First day with the company.

CURRENT POSTION START DATE

UNION SENIORITY DATE *

TRANSFER INFORMATION

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CURRENT JOB TITLE *

CURRENT REPORTING LOCATION *

CURRENT MANAGER *

TRANSFER LOCATION *

SPECIFIC DEPARTMENT

SPECIFIC SUPERVISOR

LENGTH OF TIME IN CURRENT POSITION *

SIGNATURE BLOCK

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SIGNATURE *

Use your mouse, finger, or touch device to write your signature.

With my signature, I request that my information be entered into the current year's list.

I also require a confirmation from the company's human resources department and local management that this request has been received and placed on the list.

Disclaimer: This request is submitted on behalf of the above per the collective bargaining agreement for CWA3176 (Art 9.01) and CWA3176A (Art 9.02).

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