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
Reason for termination for no rehire:
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.

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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