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Stay connected. Print and mail today.

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Your Name

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For Couple Membership, Your Spouse's/Partner's Name

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Address

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City

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State Zip Code

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Phone

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E-mail

Select type of membership:
___ Single membership $15.00
___ Couple membership $20.00

___ When possible please send me the newsletter and program reminders via e-mail.

Make check payable to IU Retirees Association and mail to:
IU Retirees Association
P.O. Box 8393
Bloomington, IN 47407-8393