Out of Work Notification
Please ensure you have submitted your hour report to your last journeyman.
I am assigned out of:
*
Anchorage (Unit 101)
Fairbanks (Unit 102)
Juneau (Unit 103)
Ketchikan (Unit 104)
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
Most Recent Employer
*
Hours to date
*
Classification:
*
Lineman
Telecommunications
Tree-trimmer
Wireman
Certificate of Fitness Expiration
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Do you have a current CDL-A?
*
Yes
No
Exemption on file
Date assigned to employer
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Date of separation
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for separation
*
Please Select
Reduction in Force (RIF)
Termination
Quit
Classroom Training
Please provide a brief explanation. The school will contact you shortly. If this is an urgent issue, please contact us.
*
Submit
Should be Empty: