PARC MEMBER INFORMATION

 Please indicate your changes/updates below

 

First Name/Middle Initial                                           Last Name                                          

Address                                                                                                                                  

City                             ______ State                                        Zip Code         ____________

Home Telephone _______________________  Cell Phone _____________________________

 

Email Address _______________________________________________________________

 

Retirement date___________________________________

 

      Your email address will be the primary method of PARC communication.

 

Your Membership Status (check one)                         Retiree          

                                                                                     Surviving Spouse/Domestic Partner

                                   

Spouse/Domestic Partner Name                                              __________________________

 

Spouse/Domestic Partner an Alcoan?            Yes                  No

 

PARC Volunteer Interest:   Yes, I would like to volunteer in one of the following areas:                    _______ Officer

_______ Appointed position (Auditor, Membership, Newsletter, Program       committee, Website, Entertainment/Cultural (circle interests)

 

Return form to: lindahparc@gmail.com.  If you have any questions, contact Linda Hurteau at this email address.

 

 

Note:  This data will be used for PARC information purposes only and will not

be distributed for any other purpose.