BEFORE YOU USE THIS REGISTRATION FORM, YOU MUST HAVE ALREADY PHYSICALLY COME TO IBEW LOCAL 2 AT 2131 59TH STREET, ST LOUIS, MO 63110 AND SIGNED UP ON THE OUT OF WORK LIST.  CALL US AT 314-645-2236, FOR DIRECTIONS.

YOUR NAME WILL NOT BE PLACED ON THE OUT-OF-WORK LIST UNTIL YOU HAVE COME TO OUR OFFICE TO REGISTER.

IBEW LOCAL 2 RE-SIGN CARD

Full Name

Address

City State (abbreviate) Zip Code

Telephone No. Date of Birth  

LU No.Card No. Classification

EMAIL ADDRESS:

Commercial Driver's License? Yes No      If yes, type 

Indicate special skills: Cable splicing Telephone Arc Welding Gas Welding  

Other

THE FOLLOWING INFORMATION IS REQUESTED TO COMPLY WITH TITLE VII OF THE CIVIL RIGHTS ACT OF 1964; YOUR ANSWER WILL BE KEPT CONFIDENTIAL & USED ONLY FOR REPORTS REQUIRED BY FEDERAL GOVERNMENT:  

MALE FEMALE
African Amer. Amer. Indian Latin Amer. Asian Other

I understand that if any of the preceding information is discovered to be incorrect or false, it will be sufficient cause for my removal from the Out-of-Work Registration List of Local No. 2, IBEW.

       
Time                 Date                     Full Name

Authorization for Representation

I authorize Local 2, IBEW to represent me in collective bargaining with my present and future employers on all present and future job-sites within the jurisdiction of Local 2, IBEW.  This authorization is non-expiring, binding, and valid until such time as I submit a written revocation.

   
                       Name