P A R C   Membership Information Sheet
Also Use for Changes

(Note:  this data will be used for PARC information purposes
only and will not be distributed for any other purpose.)

Mail Form To:        
Pittsburgh Alcoa Retirees Club (PARC)
Alcoa Corporate Center
201 Isabella Street
Pittsburgh,  PA    15212-5858   USA
Date of Change:      

First Name/Middle Initial:

Last Name

Address:
City:
State:
Zip Code:

Telephone:
Membership Status:  (check one)

     ________Retiree          ________ Surviving Spouse
Spouse Name:
  _______________________________________________ Spouse an Alcoan:   ________ Yes     ________No
Your email address can be sent directly to the PARC Website for handling:    pghparc@hotmail.com
OPTIONAL DATA (This info will be used as an activity planning tool):

Birthdate____________________________

Primary Occupational Speciality______________________________________

Secondary Occupational Speciality____________________________________

Hobbies__________________________________________________________

Volunteer Activities________________________________________________

Sports Interests___________________________________________________

PARC Volunteer Interest: 
      ______Yes, I'd  like to volunteer

      ______No, I can't volunteer at this time.
COMMENTS: