Teamsters Local 399 Membership Information Update

Update your Teamsters Local 399 Membership profile to support our data collection efforts to report the success of the incentive program.

Your name will be removed from any reporting shared with outside organizations in support of our California Film & Television Tax Incentive.

This data will be stored alongside your membership application in our Local 399 Database.

This information will also be used to help identify addtional skills that could be ultiized for ongoing campaigns, events, etc.

If you have any questions prior to completing this form, please email businessagent@ht399.org.
NAME*

First NameLast Name
NICKNAME:
This would be displayed on the availability list.
MOBILE PHONE:*
EMAIL*
example@example.com
DOB*

MonthDayYear
Date
MAILING ADDRESS:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
EMERGENCY CONTACT INFORMATION
Emergency Contact Name:*

First NameLast Name
Emergency Contact Email:*
example@example.com
Emergency Contact Phone Number: *
Please enter a valid phone number.
MEMBER INFORMATION (Self Reporting):
Yes.No.
AsianBlack / African AmericanHispanic/LatinxIndigenous American/First NationsMiddle EasternNative Hawaiian / Pacific IslanderWhitePrefer not to disclose.Not listed, please specify:
ManWomanNon-binaryPrefer not to disclose.Not Listed, please specify:
Straight (heterosexual)GayLesbianBisexualQueerPrefer not to disclose. Not Listed, please specify:
AnimalsPhotographyBi-lingualSoftware DevelopmentGraphic DesignManagementEvent PlanningVideo ProductionDrone CertifiedTeacher / InstructorCulinary ArtsMusicianMartial ArtsSports / FitnessFashionEMT / CPR CertifiedGolfBowlingArts / CraftingWritingList other Hobbies / Interests:
No.Yes, please share:
COMMUNICATION PREFERENCES:
Yes.No.
California Film and Television Tax Incentive UpdatesPolitical / Legislative UpdatesMember Action Committee Updates (Union Rallies, Solidarity Actions)Charitable Causes / Volunteer OpportunitiesShare other topics of interest:
Share any additional information you would like recorded on your profile:
Signature:

Clear
Should be Empty:

Update your Teamsters Local 399 Membership profile to support our data collection efforts to report the success of the incentive program.

EMERGENCY CONTACT INFORMATION

MEMBER INFORMATION (Self Reporting):

COMMUNICATION PREFERENCES: