Local 159 Termination Form
First Name:
Last Name:
Employer Email Address: 
Start Date:
Termination Date:
Because Of:  1. Reduction in force:
 2. Quit:
 3. Discharged for cause
Would you rehire? YES     NO
REQUIRED
Reason for termination for no rehire:
Employer: 
Please note:
Once this form is submitted a copy will be emailed to IBEW 159 & email address provided above.  You will need to print or email the form you receive to the Employee.
Enter the text shown in the image above.


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Contact Info
IBEW Local 159
5303 Fen Oak Drive
Madison, WI 53718
  office 608.255.2989 | job line 608.255.0169 from 5pm-7am Central

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