Dear Emeriti Association Member,

In order to keep our database information current, we ask you to fill in, below, the spaces that are appropriate to you.
Please email the completed form to our database coordinator by pressing the "Submit" button at the bottom of the form:

First Name:

Last Name:

ADDRESS CORRECTION (if the address on the mailing label of your copy of The Emeritimes is incorrect):

Street address:

City, State, Zip:

(or equivalent, if outside USA)

ADDITIONAL DATA (to help us maintain a more complete record for you)

Phone number (with area code and, if outside USA/Canada, country code):

E-mail address:

LISTING CONTACT INFORMATION ON THE ASSOCIATION WEB SITE

The Emeriti Association's website includes a list of all current members of the Association (Life Members and Annual Members who have paid dues for the current year). The list contains the member’s name, department and college, and years of employment and retirement. Some members have requested that contact information (address, phone number, email address) also be listed on the website. If you are a current member and would like to have your contact information added/changed on the Contact Information Page, please check below what information you would like to have shown/changed. The Contact Information Page is accessed through a separate link found on the membership page of the website and is updated approximately 1 month after each mailing of The Emeritimes.

On the contact information page, please list my: street address phone number email address

If you currently have information listed on the Contact Information Page and want your name and all contact information removed from that page, check here

Submit this form by pressing this button: