Millwrights Local 1163
Millwrights Weekly Shop Steward Report
6489 Riding Road
Syracuse, NY 13206
Phone (315) 671-0672
Email: local1163@nasrcc.org
Employers Name
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Employers Phone Number
Format: (000) 000-0000.
Job Name
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Forman Name
*
Job Address
Week Starts (Mondays Date)
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Shift
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Please Select
1st Shift (Days)
2nd Shift (Nights for 10&12 Hours)
3rd Shift (8 hours)
Members Names and Hours
Rows
Name Of Member
Member ID
Local
Mon Hours
Tues Hours
Wed Hours
Thurs Hours
Fri Hours
Sat Hours
Sun Hours
Total Hours
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2
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14
15
SHOP STEWARD
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Name
SHOP STEWARD LOCAL NO
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SHOP STEWARD EMAIL
*
example@example.com
SHOP STEWARD TELEPHONE NO.
*
Format: (000) 000-0000.
Remarks
Council Repesentative
*
Please Select
Brian Scruton
Randy Lambert
Ted Wightman
Zachary Middleton
Rep who is dealing with Job
Employer Verification:
I Verify That The Above Informantion is Correct
SIGNATURE
DATE
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Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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