WBAT

Employee Number Drawing

May's Winner(Employee Number):  547325

Please fill out form below to enter yourself in the monthly Emloyee Drawing

 

 

REGISTRATION FORM

 

 

 

EMPLOYEE NUMBER ENTRY FORM

 

Winners will be chosen at random and need not be present to win but you must claim your prize before the end of the month deadline. New winners will be announced every month. Only winners that give permission to having their names published will be posted. Therefore, while drawings are held monthly, winners may not be posted every month. It is only necessary to enter once. All names entered will remain until drawn. Prizes are mailed to work address unless alternative address is provided. Please print legibly and fax completed form along with a copy of your most recent pay stub showing employee number to (562) 425-5141 . Thank you for your participation.

 

Name:

Employee Number:   

 

Employer:

 

Phone________________ Fax_______________ E-mail_________________

 

Department________________Address________________City____________________

 

 

 

Who should we contact in your work area to arrange a benefit review?

 

 

_______________________ ____________________ ___________________

N ame Title Telephone

 

 

 

 

 

 

 

By my signature, I grant permission to having my name published if I am a chosen winner.

 

 

_______________________________________

Signature

 

 

 

 

 


Last Updated: October 18, 2007