IBEW 953 LINE CONSTRUCTION OUT-OF-WORK RESIGN FORM
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Date registered or re-registered on the Out-of-Work List
*
-
Month
-
Day
Year
Date
Book Type
*
Please Select
Journeyman Lineman
Equipment Operator
Groundman
Xcel Bench Operator
Xcel Bench Locator
Substation Tech
Utility Lineman
Book Number
*
Please Select
Book #1
Book #2
Book #3
Book #4
Check box to confirm understanding that, "I understand that I can be removed from the Out-of-Work List if (1) I refuse three offers of work; (2) I fail to re-register every 30 days or by the same day of the following month of my registration or re-registration date; (3) accept a job, then turn it down or am a 'no show' on a accepted job. After removal, I MUST re-register in person to be placed on the Out-of-Work List.
*
I Understand
Signature
*
Date
*
-
Month
-
Day
Year
Date
Upload your current dues receipt
*
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