LUCENT RETIREES ORGANIZATION (LRO)
Please support LRO endeavors by enclosing YOUR annual membership donation of $25.
First Name _________________ MI ____ Last Name _________________
City ___________________________________ State _________________
ZIP or Postal Code _________________ Country _________________Telephone _________________ E-mail ___________________________
Status: [ ] Retired [ ] Active [ ]Spouse [ ] Terminated, vested
Year of Retirement ________ [ ] Management [ ] Non-management
Company Retired From_________________________ Years of Service _____
I do not wish to share my name and address info with other members [ ].
Please mail your completed form and membership donation
to your Regional Head as shown in the table
of Regional Offices. Or mail to
The LRO is a not for profit, tax exempt organization; dues or contributions submitted by members are not tax deductible