SouthEastern States DC Interest Form

Interest Form
Name*

First Name (Nombre de pila)Last Name (Apellido)
Which organizer did you speak to? (Con que organizdor hablaste?)

BenAngeloJustinRobert
Ironworkers Union nearest to where you live? (Que sindicato de trabajadores de herreros esta cerca de usted?)

Local 92 Birmingham, ALLocal 167 Memphis, TNLocal 272 Miami, FLLocal 384 Knoxville, TNLocal 387 Atlanta, GALocal 397 Tampa, FLLocal 402 West Palm Beach, FLLocal 477 Sheffield, ALLocal 492 Nashville, TNLocal 597 Jacksonville, FLLocal 704 Chattanooga, TNLocal 709 Savannah, GALocal 798 Mobile, ALLocal 808 Orlando, FL
Street Address (Direccion)*
City (Ciudad)*
State (Estado)*
Zip Code (Codigo postal)*
Phone Number (Numero de telefono)
Email (Correo electronico)*
Preferred Language (Idioma preferido)

EnglishSpanishEnglish and SpanishOther
Types of Ironwork experience you have? (check all that apply) (Que tipo de experienca en herreria tienes?) (Marque todo logue corresponda)

StructuralPrecast ErectionDeckingHandrails and stairsMetal bldg erectionRebarPost tension cablesCranes and riggingHeavy haulCurtain wall/ Glass installationField WeldingShop WeldingIndustrial MaintenanceNone
Dpo you have any of the following certifications? (check all that apply) (Cuenta con alguna de las siguientes certificaciones?) (Marque todo logue corresponda)

OSHA 10 (Must have card)OSHA 30 (Must have card)NCCER RiggingNCCER IronworkerMSHAPhosphate Card1/8 7018 1" Stick papers1/8 7018 1/2" Stick papersForklift/LullHigh ReachCDLNone
Tools of the trade that you have (Tienes alguna de las siguientes herramientas?) (Marque todo logue corresponda)

Structural Belt with spudsWelding gearRod beltSafety harnessGlass toolsHard hat, boots, tape measureNone
List 2 Ironworking companies or maintenance companies that you have worked for (enumere 2 emptesas de herrajes para las que haya trabajajado anteriormente)
Have you worked for the Ironworkers Union in the past? (Ha trabajado para el sindicato de herreros en el pasado?)

YesNo
If so what was your book # and what local? (Si es asi cual era se numero de libro y numero el sindicado local?)
How did you hear about us? (Como te enteraste de nosotros?)

Road signNewspaperFriendOn the jobSocial MediaIndeedOther
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