For members of self-organised groups details of any SOG officer supporting you – Title First Name Initial(s) Surname Address 1 Address 2 Address 3 Postcode Contact telephone Member employment details Job title/occupation Payroll Number Employment Employment commenced ended Permanent Temporary Casual Fixed Term Full-time Part-time Job Contract share Basic hours per week Basic wage per week Basic salary per month OR £ £ Average take home pay per week Average take home pay per month £ £ Other bonuses or benefits per week Other bonuses or benefits per month £ £ Employer Head Office Name
For members of self-organised groups – details of any SOG officer supporting you Title First Name Initial(s) Surname Address 1 Address 2 Address 3 Postcode Contact telephone Member employment details Job title/occupation Payroll Number Employment commenced Employment ended Permanent Temporary Casual Fixed Term Contract Full-time Part-time Job share Basic hours per week Basic wage per week £ OR Basic salary per month £ Average take home pay per week £ Average take home pay per month £ Other bonuses or benefits per week £ Other bonuses or benefits per month £ Employer Head Office Name
24627_CaseFormAugust2017_LARGEPRINT.docx