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RETIRED MEMBERS CHAPTER |
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Region XI |
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To contact us: |
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RXI Retired Members Chapter Blacks In Government P. O. Box 77473 Washington, DC 20013 Email: RMC@bignet.org Phone: 301-567-3012 Fax: 301-567-5194 |
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RMC Membership Application (for renewals) |
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For National Office Use □□□□□□□□□□ 02/23/2008 MEMBERSHIP APPLICATION
RETIRED MEMBERS CHAPTER P.O. Box 77473 Washington, D.C. 20013
Report changes to previously submitted information (For current members)
BIG Membership Number: #___________
Old Information
Former Chapter Name: ______________________
Name (last): ______________________ First: ______________________Initial: ______ Home Address_________________________ City: ___________________ State: _______ Zip: ______ Phone: ____________________ Bus/Cell: _________________ Email: ___________________
New Information
Name (last): ______________________ First: ______________________ Initial: ______ Home Address: _________________________ City: _________________ State: _______ Zip: ______ Phone: ____________________ Bus/Cell: __________________ Email: ____________________ Misc. Data: ___________________________
Formal date of resignation from Former Chapter: _____________________ |
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“Committed to Equity, Excellence and Opportunity"
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