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Fields in red are required Name: 31846 Pen Translucent Black Barrel, Black Ink 31854 Pen Translucent Black Barrel, Blue Ink 31843 Pen Translucent Purple Barrel, Black Ink 31851 Pen Translucent Purple Barrel, Blue Ink 31821 Pen White Barrel/Translucent Orange Trim, Black Ink 31825 Pen White Barrel/Translucent Orange Trim, Blue Ink 31822 Pen White Barrel/Translucent Turquoise Trim, Black Ink 31826 Pen White Barrel/Translucent Turquoise Trim, Blue Ink 31827 Pen White Barrel/Translucent Lime Trim, Blue Ink 31835 Pen White Barrel/Black Trim, Black Ink 31823 Pen White Barrel/Translucent Lime Trim, Black Ink 31829 Pen White Barrel/Black Trim, Blue Ink 31840 Pen Translucent Red Barrel, Black Ink 31824 Pen White Barrel/Navy Trim, Black Ink 31828 Pen White Barrel/Navy Trim, Blue Ink 31839 Pen White Barrel/Red Trim, Black Ink 31833 Pen White Barrel/Red Trim, Blue Ink 31836 Pen White Barrel/Forest Green Trim, Black Ink 31830 Pen White Barrel/Forest Green Trim, Blue Ink 31837 Pen White Barrel/Bright Blue Trim, Black Ink 31831 Pen White Barrel/Bright Blue Trim, Blue Ink 31838 Pen White Barrel/Purple Trim, Black Ink 31832 Pen White Barrel/Purple Trim, Blue Ink 31848 Pen Translucent Red Barrel, Blue Ink 31810 Pen White Barrel/Blue & Red Trim, Black Ink 31800 Pen White Barrel/Blue & Red Trim, Blue Ink 31811 Pen Yellow Barrel/Black Trim, Black Ink 31801 Pen Yellow Barrel/Black Trim, Blue Ink 31812 Pen Yellow Barrel/Bright Blue Trim, Black Ink 31802 Pen Yellow Barrel/Bright Blue Trim, Blue Ink 31813 Pen Yellow Barrel/Red Trim, Black Ink 31803 Pen Yellow Barrel/Red Trim, Blue Ink 31853 Pen Translucent Teal Barrel, Blue Ink 31841 Pen Translucent Bright Blue Barrel, Black Ink 31845 Pen Translucent Teal Barrel, Black Ink 31849 Pen Translucent Bright Blue Barrel, Blue Ink 31847 Pen Translucent Burgundy Barrel, Black Ink 31855 Pen Translucent Burgundy Barrel, Blue Ink Product Name: Address: Imprint Color(s): City: Quantity: State: Zipcode: Additional Information: Phone: Email: AFSCME 1199C (Health Care Workers) AFSCME District Council 33 AFSCME Local 1971 (DC 33) AFSCME District Council 47 AFSCME DC47 Local 2186 AFSCME DC47 Local 2187 AFSCME Local 1739 (DC47) AFSCME District Council 88 AFSCME Local 427 (DC33) AFSCME Local 696 Allied Printing Trades Council Phila. American Federation of Government Employees (AFGE) Local 940 American Federation of Television and Radio Artists (AFTRA) Phila American Postal Workers Union (APWU) Philadelphia APWU Philadelphia BMC Local 7048 Bakery, Confectionery, Tobacco Workers and Grain Millers Local 492 Bakery, Confectionery, Tobacco Workers and Grain Millers Local 6 Boilermakers (IBB) Local 19 Brotherhood of Maintenance of Way Employes (BMWE) Philadelphia Communication Workers of America (CWA) Local 13000 Faculty and Staff Federation of CCP (AFT Local 2026) Fire Fighters (IAFF) Local 22 Firemen Oilers (SEIU) Local 1201 Flight Attendants (AFA) Local 70 FOP Local 5 Gas Workers UWUA Local 686 Glass, Molders, Pottery, Plastics and Allied Workers (GMP) Phila. Graphic Communications Union Local 14-M Graphic Communications Union Local 16-N Graphic Communications Union Local 4-C Health and Professional Allied Employees (HPAE) Local 5103 Red Cross Hotel Employees Restaurant Employees (UNITE HERE) Local 274 IBEW Local 126 IBEW Local 744 Railroad International Alliance of Theatrical Stage Employees (IATSE) Local 8, AFL-CIO International Association of Machinists and Aerospace Workers (IAM) Local 1776 International Association of Machinists and Aerospace Workers (IAM) Local 447 International Longshoremen's Association (ILA) Local 1242 International Longshoremen's Association (ILA) Local 1291 International Longshoremen's Association (ILA) Local 1566 IUE Local 123 IUE/CWA Local 120 Musical Society of Philadelphia - American Federation of Musicians Local 77 National Association of Letter Carriers (NALC) Branch 157 Phila. Newspaper Guild 10 Newspaper Guild-CWA Local 38010 OPEIU 63/PA Pharmacists Assn OPEIU Local 277 Operating Engineers Local 716 GET-UP (U. of Penn.) Paper, Allied-Industrial, Chemical, Energy Workers (PACE) #2-1 Paper, Allied-Industrial, Chemical, Energy Workers (PACE) #2-667 Pennsylvania Liquor Enforcement Association (P.L.E.A.) Philadelphia Building and Construction Trades Council, AFL-CIO Boilermakers (IBB) Local 13 Bricklayers and Allied Craftworkers Local #1 Bricklayers and Allied Craftworkers Local #2, Cement Masons and Plasterers Carpenters Regional Council Floorlayers Local 1823 Mill and Cabinetmakers Local #359 Millwrights Union Local 1906 Wharf and Dockbuilders Local 454 Cement Masons and Plasterers Union Local 592 District Council 21 Elevator Constructors Local 5 Glaziers Local 252 IBEW Local 269 IBEW Local 380 IBEW Local 654 IBEW Local 98 International Brotherhood of Electrical Workers Insulators and Asbestos Workers Local 14 Insulators and Asbestos Workers Local 89 Ironworkers District Council Allentown Ironworkers Local Union 401 Ironworkers Local Union 502 Ironworkers/Rod Setters Local Union 405 Laborers' District Council of the Metropolitan Area of Philadelphia and Vicinity (LDC) Laborers Local Union 135 Laborers Local Union 332 Laborers Local Union 413 Laborers Local Union 57 Operating Engineers Local 542 Operating Engineers Stationary Local 835 Plasterers Local #8 Plumbers Local Union 690 Roofers Waterproofers Local 30 SEIU Firemen Oilers Local 473 Sheet Metal Workers Local Union 19 Signmakers Hangers Local Union 194 Sprinkler Fitters Local Union 692 Steamfitters Local Union 420 Teamsters Local Union 384 Teamsters Local Union 470 Philadelphia Federation of Teachers (PFT) Local 3 Philadelphia Legal Services Union (PLSU) UAW Local 2320 PSSU-SEIU Southeast Chapter Retail Workers and Department Store Union (RWDSU) 1034 School Cafeteria Workers (H.E.R.E.) Local 634 Seafarers International Union of North America (SIU) Philadelphia SEIU Local 252 SEIU Local 32BJ District 36 SEIU Local 668 PSSU Philadelphia Chapter Sports Arena Employees Local 137 TAUP Local 4531 (AFT Temple U.) Teamsters District Council 500 Teamsters Local 463 Teamsters Local 502 Teamsters Local 830 Temple University Graduate Students Association (TUGSA) AFT 6290 Transport Workers Union of America (TWU) Local 234 UAW Region 9 (CAP) UFCW Local 1776 UFCW Local 56 Bread and Roses Philadelphia Citizens for Consumer Justice Philadelphia Friends Center Greater Philadelphia Urban Affairs Coalition Peggy Browning Fund Philadelpha Chapter Coalition of Labor Union Women Philadelphia Area Jobs with Justice Philadelphia Area Project on Occupational Safety and Health (PHILAPOSH) Philadelphia Unemployment Project (PUP) Philadelphia Work Force Development Corporation (PWDC) Solutions for Progress, Inc. UNITE! PA, OH, and South Jersey Joint Board UNITE! Philadelphia Joint Board United Independent Union Local 1United Independent Union Local 1 United Independent Union Local 2004 United Independent Union Local 9 United Independent Union Local 9A Your Union:

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