Current members, please complete & return ONLY if
you have CHANGES
City ______ State Zip Code ____________
Your Membership Status (check one) Retiree
Surviving Spouse/Domestic Partner
Spouse/Domestic Partner Name __________________________
Spouse/Domestic Partner an Alcoan? Yes No
Email Address: _______________________________________________________________
How would you like to receive communications? __________ Email
or __________ USPS
Secondary Occupational Specialty
Yes, I would like to volunteer in the ______ No, I cannot
following area(s): volunteer at this time.
_______ Appointed position ( Auditor, Membership, Newsletter, Program Committee, Website, Entertainment/Cultural) (circle interests)
If you have any questions please contact Linda Hurteau or e-mail firstname.lastname@example.org
Note: This data will be used for PARC information purposes only and will not be distributed for any other purpose.