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Sign Books (Any IBEW Member)

* Required Fields
** Required Field for Local 1393 Member
*Soc. Sec. No. (XXX-XX-XXXX):
Birth Date (MM/DD/YYYY):
*Local No.:
**Card No 1:
*Driver's License: Yes No
*CDL (Permits are not allowed) 1: A B None Haz-mat Tanker
* First Name:
* Last Name:
*Address:
*City: *State: *Zip:
*First Phone Number (XXX-XXX-XXXX):
Second Phone Number (XXX-XXX-XXXX):
*Email:
* Enter the maximum number of miles that you are willing to travel from your house:

Please check all that you have experience in or with:
Transmission
Distribution

Underground
Substation

Wind Farm
STLT/Signals

Telephone
Cable Splicer

Directional Borer
Borer Locater

Trencher
Crane

BackHoe
Flat Bed

Semi
Pressure Digger

Dump Truck
Track Hoe

Excavator
Boom Truck

Dozer
Steel Towers

Welding
Foundations

NCCCO Certified1
Can't Climb

ALBAT Grad
OSHA T&D1

OSHA 101
OSHA 301

First Aid/CPR1
Skid Loader1

1 Must provide a copy of applicable NCCO Certification, Most Recent Dues Receipt, CDL, Medical Card, First Aid/CPR, and/or OSHA Card(s) by Email to alex@webconnectivity.com

Please read the following before submitting this form:

  • By submitting this form, you are affixing an electronic signature to this document.
  • I hereby assign to Local Union 1393, International Brotherhood of Electrical Workers, AFL-CIO, from any wages earned or to be earned by me as a member, a flat rate per month for initiation fees and working dues, or such amounts as may hereafter be established by the Union and become due to it, as my membership dues in said Union. I authorize and direct you to deduct such amounts each month from my pay and to remit the same to the Union.
  • I further assign and transfer into Local Union 1393, out of wages to be earned by me as a result of my employment, any such monthly Local Union dues now owing by me for a period not to exceed three (3) months prior to this date.
  • This assignment, authorization and directive shall become operative contemporaneously with the effective date of any new collective bargaining agreement between the Employer and the Union, which shall succeed the current collective bargaining agreement between the same parties.
  • This assignment, authorization and directive shall be revocable by me at any time, but shall be in full force and effect until revoked by me by giving written notice to both the Employer and the Local Union, such notice to be signed by me and mailed via certified mail to the Employer and the Local Union
  • Fees, dues and assessments covered by this authorization are not deductible as charitable contributions for federal income tax purposes.


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