Retiree Jacket Application
Congratulations on retiring.

Please fill out this form to apply for a Teamsters Local 623 Retiree Jacket. Fill out this form by the first of the month to have your application reviewed at that month's Executive Board meeting. Jacket applications from retirees with less than 25 years service will have to be approved by the Executive Board.

Once approved, jackets may take up to six (6) weeks to process for pickup or shipment.
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Email *
First Name *
Last Name *
When did you retire?
MM
/
DD
/
YYYY
Phone Number *
Address
City, State & Zip
Email
Jacket
We offer three jackets for retiree gifts. Photos of each can be found at the 623 Online Store.
Size
What name do you want on the jacket?
Please write the name you want embroidered on the jacket. For example, if you want only your first name write "John".
Do you want to "RETIREE" under your name?
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