Please remember to write "Do not publish" on the line next to any information that you do not wish to appear in the membership directory.

 

Name___________________________________________________________________

 

Address__________________________________________________________________

 

City/State/Zip code__________________________________________________________

 

Telephone number   (               )________________________________________________

 

Email Address_____________________________________________________________

 

County Department from which you retired_______________________________________

 

Month & year of retirement___________________________________________________

Print this page, complete information below and mail the form with a check for $10.00 payable to FCREA to:
Fulton County Retired Employees Association, Inc., P. O. Box 201, Grayson, Georgia 30017-0004

Application for Membership

Fulton County Retired Employees Association, Inc.

Atlanta, Georgia