Application for Membership

Membership Application

RETIREE/EMPLOYEE:

DNR

DEQ

EGLE

SPOUSE/PARTNER:

Primary Address:

Street Address:

City, State, Zip Code:

Seasonal Address:

Seasonal Street Address

Seasonal City, State, Zip Code:

Dates of seasonal address:

Email (Retiree):

Phone number:

Email (Spouse/Partner):

Alternate phone number:

How do you want to receive the newsletter?

Emailed newsletter

Printed newsletter

How did you learn about the Association?

Information for the newsletter

First year of new membership is free. You may extend your membership for additional years at $10 per year by submitting a form to renew membership on the Membership page.

If you listed an e-mail address, you will receive a copy of the Membership Directory via email within 30 days, and a password to access the Member Portal page.

If you do not have an e-mail account, you can request a Member Portal password by clicking on the Contact Us page. You can order a printed copy of the Membership Directory at $12.00 per copy from the Member Portal.

Thanks for applying!

DNR, DEQ, & EGLE Retirees Association

Membership Application