Book Removal Form

IBEW LOCAL 234

747 El Camino Real Salinas CA 93907
831-633-2311
Book Removal
Fill out this form and submit to have your name removed from the Out-of-Work Books.

It is you responsibility to remove yourself from the Out-of-Work List when you are unable to take a call.
Book Removal for *, *
Name:*

First NameMiddle NameLast Name
Last Four of SSN:*
Card #:*
Home Local #:
Email:*
example@example.com
I agree to share the information above, including the last four digits of my social security number, with the IBEW Local 234.
Your Signature:*

Clear
Your SSN will be kept secure and not shared outside the use of the Information Card
Date:*

MonthDayYear
Date
Hour MinutesAM/PM Option
Should be Empty: