IBEW LOCAL 17 RE-SIGN FORM

You must re-sign your name beginnning the 10th and ending the 16th of each month to remain on the books. Failure to do so will result in your name being removed from the books.

LAST NAME

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FIRST NAME

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IBEW HOME LOCAL UNION #

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IBEW CARD NUMBER (IF AN IBEW MEMBER)

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BOOKS

AGREEMENT

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BOOK NUMBER

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CLASSIFICATION

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