Nortel Networks Retirees' Association Membership
Information Change Confirmation Form


FirstName ,

Thank you for letting the NNRA know of your information changes so we can kept our records up-to date so that you can be keep informed of events and activities in the NNRA.  You can print this form and keep it for your records.  An email has automatically been sent to the NNRA Treasurer so your information can be updated.

You will receive a notification when the change has been made.

You can  PRINT this form for for your records.
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Your Information
Name: First FirstName


Init Last: LastName
Spouse: Spouse
Address 1: Address1
Address 2: Address2
City: City State: State
Zip 1: Zip1

Zip 2:

Phone Nbr: PhoneNbr Cell/Other Phone: CellPhone
Email: Email
Communication Type: Email CommunicationTypeEmail US Mail: CommunicationTypeUSMail
Change  Date RegistrationDate