This will be used for all correspondence and work notifications.

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Please provide images of the front and back of each of your licenses and certificates.

Release and Confidentiality Statement: I understand that I am submitting this personal information in confidence to Local 30 for the purposes of facilitating further communications between me and Local 30 and assisting Local 30 in providing membership services. I also understand that this personal information will be shared with third party service providers retained by Local 30 for these purposes, and that Local 30 will take all reasonable precautions to protect the privacy of my personal information that are consistent with these purposes. The aforementioned communications include, but are not limited to, inter-emails, inter-messaging, communications with the Local 30 dues office, administrative communications and any communications relating to planning and coordinating, all of which may be required from time to time. I confirm that all of the information I am providing is current and I further confirm that I am digitally signing this as my release and permission to store information that I provide on Local 30 servers to facilitate such communications between and amongst me, Local 30, other Local 30 members, Local 30 staff, and third party service providers retained by Local 30.