ASSOCIATION OF RETIRED SCS EMPLOYEES (ARSCSE) APPLICATION for MEMBERSHIP

The membership year is the calendar year (January 1 - December 31).

Name________________________________________ Spouse________________

Address____________________________________________________________

City______________________________ State__________ Zip_____________

Type of Membership (Check one)

_____1. COMPLIMENTARY MEMBER (Voting): No Dues.

(Anyone retiring or leaving NRCS after Jan. 1, 2003 is eligible.
All that is required is to complete and submit this Application Form.)

_____2. MEMBER (Voting) Retired SCS/NRCS employee.   Dues $12/yr
_____3. AFFILIATE (Nonvoting) Active NRCS employee.   Dues $12/yr
_____4. LIFE (Voting) Retired SCS/NRCS employee.   Dues $125

(New members may pay for quarters of year remaining @ $3.00.)



Title (at retirement)_____________________________Date Retired______________

Career Discipline_______________________________________________________
{Such as Soil Scientist, Cons. Tech., Engineer, Economist, Personnel, Agronomist Biologist, etc.}

Date of Birth_________________________ Phone No.(______)__________________

Email Address______________________________________________________

Other _____________________________________________________________



Signature____________________________________________________________

Please make checks payable to ARSCSE and mail to:

ARSCSE
P.O. Box 523615
Springfield, VA    22152-3615


Application provided by (print name)_______________________________________________

PURPOSE of ARSCSE
To keep retirees in touch with other ARSCSE members and to exchange experiences, ideas, and activities, and to alert members of retiree activities at local, state and national levels.
To encourage continued support of sound soil and water conservation programs carried out by NRCS, and other agencies, and to keep retirees informed of current conservation legislation, budgets, and program changes.