IBEW 953 Out Of Work Form

IBEW 953 LINE CONSTRUCTION OUT-OF-WORK REGISTRATION FORM
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
Phone Number
Format: (000) 000-0000.
Social Security Number
Full social is required
Gender
Ethnicity
IBEW Local #
IBEW Card Number
Membership Type
Job Classification
Dues Paid Thru Date

MonthDayYear
Date
Are you signing the books for unemployment purposes and not looking to work this winter?
Book Type
What book would you like to sign?
Book Number
Equipment and Field Experience - (Please check the equipment you can operate WELL and the field experience you have. Check only categories you have experience in)

Other
Please type what JATC program you graduated from, or list what IBEW Local gave you your Journeyman Lineman test
Year Graduated
Preferences
I have read and understand the Employment Referral Procedures of the IBEW 953/2150 Outside Power, Commercial Line and Tele-Data Agreements. I, the undersigned, agree to abide the posted referral procedures of IBEW Local 953. Applicants MUST re-register EVERY MONTH FROM THE LAST REGISTRATION DATE to remain eligible on the OUT-OF-WORK List. Re-registrations will NOT be accepted beyond one month of your previous registration date.
Signature
Date

MonthDayYear
Date
Current Dues Receipt

Cancelof
Drivers License/CDL

Cancelof
Certifications ex. Crane

Cancelof
Should be Empty:

IBEW 953 LINE CONSTRUCTION OUT-OF-WORK REGISTRATION FORM