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OFFICE AND PROFESSIONAL EMPLOYEES INTERNATIONAL UNION APPLICATION FORM |
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Name of Applicant: ___________________________________________________________________ Home Address: ___________________________________________________________________ ___________________________________________________________________________________ Date of Birth: ______________________ Sex: M ___ F ___ Soc. Sec. # _____________________ Member/Associate Member Name: ______________________________________________________ Home Address: ___________________________________________________________________ ___________________________________________________________________________________ Member/Associate Member Employed By: _______________________OPEIU Local Union ________ Relationship to Member/Associate Member: Son ___ Daughter ___ Other ______________________ If my child is selected for this scholarship, I fully agree to adhere to the rules that have been established by the Scholarship Committee. Signature of Parent of Applicant _____________________________________ Date: ______________ Signature of Local Union President or Secretary-Treasurer: _______________________________ Date: ___________________ Local Union Number _________ __________________________________________ The Summer Camp is held during August of each year, at University Forest Environmental Education Center, University of Missouri, Route 2, Box 139, Williamsville, MO 63967, (573) 222-8373, Fax (573) 222-8829. SEND APPLICATION AND INQUIRIES TO: |
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