New members, or for changes, please complete


First Name/Middle Initial                                           Last Name                                          


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:  If you have any questions, contact Sue Zemba at 412-360-9216 (leave a vmx) or at this listed email address.



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

be distributed for any other purpose.