MURA Complimentary Membership Form

MURA Complimentary Membership Form

Complete online or mail paper copy to MU Retirees Association, PO Box 1831, Columbia, MO 65201-1831
Member Information
Are you registering for yourself or yourself and a spouse/partner?
Member Name:

First Name(s)Middle Name Last Name
Preferred Name for Name Tag:
Address:

Street Address

Street Address 2

CityState

Zip Code
Cell Phone:
Format: (000) 000-0000.
Home Phone Number
Format: (000) 000-0000.
E-mail:
Membership Category:
Member Optional Information
Retirement Date:

MonthDayYear
Date
Position Type:
Gender:
Preferred Pronoun:
Member Volunteer Opportunities
I am interested in serving in the following:
I am interested in learning more about MURA Committee work (check all that apply):
- Spouse/Partner Information (if they are also joining MURA)
- Spouse/Partner Name:
  
  First Name(s)Middle Name Last Name
- Spouse/Partner Preferred Name for Name Tag:
- Cell Phone:
  Format: (000) 000-0000.
- Email:
- Membership Category:
- Retirement Date:
  
  MonthDayYear
  Date
- Position Type:
- Gender:
- Preferred Pronoun:
- I am interested in serving in the following:
- I am interested in learning more about MURA Committee work (check all that apply):

Member Information