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.