Communications | Employer Request for Journeyperson

Requests MUST be submitted by 2:30pm

Referral Dept | Joe Smolinski
Jeff Kingsley | Dispatch Business Agent
P: (312) 466-8300 | F: (312) 466-8313
Email: referral@local134.org

Date Date / MM / DD YYYY
Employer
Time Time : HH MM AM/PM
Person Making Request Person Making Request First Last
# of Employees Requested
Type of Work

Type of Work Commercial Residential Industrial Jobbing
Starting Date Starting Date / MM / DD YYYY
Starting Time

Starting Time 6:00am 7:00am 8:00am Other Other
Where to Report / Shop / Jobsite Address Where to Report / Shop / Jobsite Address
Street Address City State / Province / Region
Shop | Phone # Shop | Phone # - ### - ### ####
Jobsite | Phone # Jobsite | Phone # - ### - ### ####
Duration of Work:

Duration of Work: Short call | 14 Calendar days or less 2-3 Weeks 1 Month 2 Months Indefinite
Work is:

Work is: Inside Outside Both
Remarks or Requirements
Person to Report to: Person to Report to: First Last
Directions if Needed