Membership Application
National Association of Retired and Veteran Railway Employees, Inc.

Your membership helps NARVRE protect your retirement benefits as granted by the Railroad Retirement Act. Please pass the word to your railroad friends about the benefits of NARVRE.

Yearly Dues	Extended Membership
		Single	Couple	Date:	___________________	19____
Person: $12.00	Five Years:	$55	$75
	Ten Years:	$80	$110	Date of Birth:	Month:___Day:___Year:___
Couples: $19.00	Life:	$110	$150	Retiree:	Yes: ______ No: ______
				Date Retired:	___________________
	Years of Service: ______ Union Membership:___________________ Name of Railroad: _________________________________________ Railroad Occupation: _______________________________________ Name: ___________________________________________________ Spouses Name: ___________________________________________ Street or Box No.: _________________________________________ City: _________________ State: _______ Zip Code: ________-_____ Telephone No: _(____)______-__________ If you would like to be placed in a specific Unit, please indicate: _____