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2008 MEMBERSHIP APPLICATION / RENEWAL FORM
EXXONMOBIL ANNUITANT CLUB OF THE MORRIS AREA
EACMA is open to ExxonMobil retirees and their spouses. Additional information about membership eligibility may be found by going to www.eacma.org and clicking on the By-Laws link in the left margin.
Membership fee is $10 per person (= $20 per couple) if received before the start of the renewed year. Membership renewals sent after December 31 are at DOUBLE RATES (i.e. $20/person = $40/couple) because ExxonMobil does not subsidize us for late renewals. Please complete this application and return to Bob Garman, 26 Dogwood Drive, Madison, NJ -07940-2609. If you have questions, please call Dorris Harris on 973-887-5108 or her at membershipchair@eacma.org.
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TO: Doris Harris, 34 Adams Drive, Whippany, NJ 07981-2051
Enclosed is my Check No. _______ payable to EACMA for $___________
to cover - - - - - - ___ one or ___ two memberships as follows:
Annuitant ________________________ Spouse __________________________
Email address (if you have one) ________________________________________
(
Please provide email address even if it has not changed since your last
membership application. We find that often the Club records are out of
date, or members have forgotten to notify us of changes.)
Membership Type ___ Regular Member ___ Associate Member
NOTE: If you check "Regular
Member", then you are designating the EXXONMOBIL ANNUITANT CLUB OF THE MORRIS AREA (also known as EACMA) as your primary Annuitant Club thus allowing us to benefit from ExxonMobil's subsidy. Alternatively, if you choose another Annuitant Club as your primary club, then please check "Associate
Member." Because your other club will receive the subsidy, you will be subject to slightly higher fees for EACMA luncheons and activities.
How would you like to receive our newsletters? (ONE CHOICE ONLY, PLEASE)
___ Paper copy by ordinary US mail
___ Electronic (If you select this, then we will send you an email with the newsletter attached. That same email will also contain a link to our website where that same newsletter will be posted.).
The club strongly encourages the Electronic option if you have the capability.
U.S. mail is expensive and labor-intensive to print, collate, label, and mail.
Email may be sent to both the annuitant and the spouse.
If you want both, then please list the second email address here: ________
NEW MEMBERS ONLY
(unless there are changes):
PHONE: ( ________ ) _________ - ____________________
MAILING ADDRESS: ___________________________________________________
___________________________________________________
Please provide Social Security Number(s) (SSN's) and retirement information below for use by ExxonMobil Annuitant Affairs, Houston:
Annuitant SSN ______/______/_______ Retirement Date ___________________
Retired from (name of ExxonMobil Origination) ____________________________
Spouse SSN _____/_____/______ Or Surviving Spouse SSN _____/____/______
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