Sign-In Form

IBEW LOCAL 234
747 El Camino Real Salinas, CA 93907
831-633-2311
Local 234 Sign-In/Re-sign
Name:*

First NameMiddle NameLast Name
Last Four of SSN:*
Phone:
Please enter a valid phone number.
Email:*
example@example.com
Zones - Check All That Apply:*

Zone 1: North Monterey CountyZone 2: South Monterey CountyZone 3: Santa Cruz CountyZone 4: San Benito County
I agree to share the information above, including the last four digits of my social security number, with the IBEW Local 234.
Your Signature:*

Clear
Your SSN will be kept secure and not shared outside the use of the Information Card
Date:*

MonthDayYear
Date
Hour MinutesAM/PM Option

Local 234 Sign-In/Re-sign