APPLICATION for LABORERS & CONTRACTORS Training Center


Enter Local

(Course Title/Date)


(last 4 of social security number) Enter Last 4 of SSN in the format XXXX

(First) Enter First Name  

(mi)Enter Middle Name

(last)Enter Last Name

(jr/sr) Enter Jr or Sr

(street address / route / box or apartment number) Enter Street Address

(city) Enter City

(state) Enter State

(zipcode) Enter Zip Code

(CELL number) Enter Cell Phone in the format: (XXX)XXX-XXX

(EMAIL address) Enter your email.
- -
(date of birth) Enter your date of birth
ARE YOU PRESENTLY EMPLOYED:

Enter if you are presently employed.
Name of present or most recent:
Enter Contractor
Local No:
Enter Local Number

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Signature:
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Date:
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***************************must be completed by local union office ***************************

I hereby certify that this person is a member in good standing of Local _______ and has worked for the contributing contractor named above.

Member’s Admission/Readmission Date is: _______/_______/_______.

Dues paid through ___________________________.

Signed: ___________________________________________         Date: ________________

Title: ____________________________

{Class Application Informartion:body}

LABORERS' LOCAL 42

301 South Ewing Avenue
St. Louis, MO 63103
Phone: 314.531.1187
Email: laborers@local42.us
Website: www.liuna42stl.com

LABORERS' LOCAL 110

4532 South Lindbergh Boulevard
St. Louis, MO 63127
Phone: 314.892.0777
Email: sschwartz@lu110.com
Website: www.lu110.com

LABORERS' LOCAL 660

1320 South Callahan Road
Wentzville, MO 63385t
Phone: 636.946.8766
Email: sarah@laborers660.org
Website: www.liuna660.com

LABORERS' LOCAL 662

209 Flora
Jefferson City, MO 65101
Phone: 573-635-1441
Email: laborers662@gmail.com
Website: www.liuna662.com

LABORERS' LOCAL 840

10760 County Road 2000 (North Y)
Rolla, MO 65401
Phone: 573.364.3928
Email: laborerslocal840@gmail.com
Website: www.liuna840.com

LABORERS' LOCAL 955

404 Tiger Lane
Columbia, MO 65202
Phone: 573.499.3720
Email: laborers955@gmail.com
Website: www.liuna955.com

LABORERS' LOCAL 1104

773 Enterprise
Cape Girardeau, MO 63703
Phone: 573.334.7722
Email: local@laborers1104.org
Website: www.liuna1104.com