RCnews-Form

The Retiree Club

An organization of Perkin-Elmer retirees and other former employees

Please check your address label on the envelope of your news letter for your expiration date.

It's time for The Retiree Club 2008 Membership Renewal. Yearly dues are still a modest $5.00 to defray the cost of our newsletter mailings, insurance coverage, and contingencies. Deadline for payment is March 1st. You can enroll for a multiple-year period as follows: $5.00 for 2008; $10.00 for 2008 & 2009; $15.00 for 2008, 2009, & 2010; or $20.00 for 2008, 2009 2010, & 2011. Note that you can join the Retiree Club if you are retired or are a non-retired former employee of the Perkin-Elmer Corporation. Please type or print clearly.

Name:_________________________ Spouse:__________________

Address:______________________________________

e-mail address:_________________Phone:_______________

Please tell us a little bit about what you are doing: Interests? Activities? Other? We would like to to know. Just a few lines for the Mail Bag, - a short "Letter from Home." Thanks.

_____________________________________________________

_____________________________________________________

________________________________________________________

____________________________________________
    (Please feel free to add a separate note if you need more room for your "Letter from Home"        ."

Membership Directory
    Do we have permission to release your name and address to those members who are interested                 in in membership lists for their areas?
Check here,____ if Yes          Check here,____ if No

Your approval signature:____________________

Enclosed is:___ $5.00 dues check for 2008
or
            ___$10.00 dues check for 2008 & 2009
___$15:00 for 2008,2009,2010
          ___$20:00 for 2008, 2009,2010, 2011

Mail this form and your check to:
The Retiree Club,
P.O. Box 108,
Norwalk, CT 06852-0108