On-line Resign Form

ATTENTION:  Referral Agent

I am currently registered on of the Local Union 124 Out-of-Work list.  Please resign my name for the month of   .

Full Name

Member of Local Union No.       Card No.

Last 4 digits of Social Security No.

Phone Number      Alternate Phone Number

E-Mail Address  

                     

Print the following page as your receipt.

Resigns must be date / time stamped on or between the 20th of the month preceding and the 7th of the month following the 1st of the month you are resigning for.  (Example:  A resign for the month of August, 2006 must be date stamped on or after July 20th AND on or before August 7th.)

 

copyright 2007 - IBEW Local 124