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Qwest Legacy CWA Logo Uniform Patch Order Form
Questions marked by * are required.
1. Full Name: *
2. Local *
3. Home Address *
4. Email:

This form is for Legacy Qwest Outside Technicians members only as part of our 2012 bargaining.

We are having problems with members NOT putting in their entire street, city, state and zip code.  Please type in your entire home address!!

(If you enter your email, once submitted, a copy of the answers will be sent to the email address you provided.)

Each Member will be sent 5 patches for their uniform shirts by the Union vendor.

Note: The Vendor is not allowed to use the member's information for any other purpose.

Orders will be reviewed at this office to validate membership status and then sent to the vender to be filled/mailed.


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Last updated: November 09, 2015.