Confirmation (Re-Sign) Form

CONFIRMATION (Re-Sign) NOTICE FOR IBEW LOCAL UNION No. 191
Print Full Name:*
Today's Date:*

MonthDayYear
Date
L.U. No.
IBEW Card No.
Classification:*
Confirming for (Month & Year):*
Email Address:*
example@example.com
Signature:*
This form to be filled out and emailed to dispatch@ibew191.com before the end of the month for which you are confirming.
Should be Empty: