Current members, please complete & return ONLY if
you have CHANGES
First
Name/Middle Initial
Last Name
____
Address
____
City
______
State
Zip Code
__________
Telephone
____
Email
Address:
_______________________________________________________________
Your email address will be the primary method of PARC communications.
Your
Membership Status (check one)
Retiree
Surviving
Spouse/Domestic Partner
Spouse/Domestic
Partner Name
__________________________
Primary
Occupational Specialty
Secondary
Occupational Specialty
PARC
Volunteer Interest:
Yes,
I would like to volunteer in the
______
No, I cannot
following
area(s):
volunteer at this time.
_______ Board
_______ Officer
_______ Appointed position
( Auditor, Membership, Newsletter,
Program Committee,
Website, Entertainment/Cultural)
(circle interests)
Mail to: PARC, 201 Isabella St.,
Pittsburgh, PA 15212-5858
If you have any questions please contact Linda Hurteau or e-mail pghparc@hotmail.com