Construction Registration Form

Teamsters Local 222 CONSTRUCTION Industry

Registration For Employment
Date:*

MonthDayYear
Date
Last Name*
First Name*
Middle Name
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Social Security Number*
Driver's License Number:*
Number
State*
Class*
Endorsements*
Restrictions
Birth Date*

MonthDayYear
Date
Are you Registered elsewhere?*
If YES, Where?
Male or Female (M/F)?*
Are you presently employed?*
If so, Where?
Email*
example@example.com
Please list companies you will not or cannot work for:*
I have read the Exclusive Hiring agreement referred to in the Utah Branch, Inc. of the Associated General Contractors of America, Inc. and Teamsters Local Union 222, and I hereby register as provided, and certify that I am qualified to perform the duties required in the classifications checked below, and I am not registered on any other construction list within the geographic area ofthis Agreement.
Signature:*

Clear
List proof of at least two years of actual experience in the building, heavy & highway construction industry:
Classification:*

ArticulateBusBelly DumpBottle TruckCement MixerChallenger/Marooka (Pipeline)Dump TruckFlat Rack TrucksFloat (Pipeline)Foam TruckForkliftFuel/Oil Tank TrucksGrapple TruckMechanic with RigOil Spreader OperatorSemi-TruckSkid TruckStringer TruckStrong ArmSweeper or Vacuum TruckTransfer Dump TruckTransport Truck/LowboyWater Trucks (Conventional)Water PullWarehousemanWinch/Boom
List any Other Special Experience/Equipment applicable for this industry:
This registration must be accompanied by cash, check, money order, or credit card for the Hiring Hall fee of $16.00 (per month) as well as a copy of your Drivers License, DOT Card, and a Membership Application. Please call our office at 801-972-1898 ext. 20 or 21 to pay the fees. Do not mail or fax to Local Union as it will not be accepted without required documentation & fee.

We will keep your registration form on file for two weeks (ten business days). If we do not receive payment within those two weeks, your registration form will be shredded.
Please upload a copy of your Driver's License, front and back.*

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