Forms

Forms

Change of Address

Membership Application

Replacement Waiver

Full-Time Waiver

Withdrawal Card Information

To qualify for a withdrawal card, you must be a fully initiated member and be current in your monthly dues. By requesting a withdrawal card, you will avoid repaying the initiation fee when you re-enter the industry. This request must be received within 45 days of your last day of active employment. You must request a withdrawal card every time you leave the industry.

To receive a withdrawal card, fill out the form, print and send in to:

UFCW Local 653
Attn: Membership Accounting
6160 Summit Dr N, Suite 600
Brooklyn Center, MN 55430

Or you can e-mail your request.

If you should have any questions, please feel free to contact Suzi at the union office at 763-525-1500 or 1-800-292-4105.
UFCW Local 653- Thank you so much for the gift cards I received at the Health Fair. I thought the Health Fair was a huge success. It was informative and fun. The free immunizations were great! I hope you continue to have the Health Fair. Thank you again! - Carol