Hopefully, this form will prompt many of you to join AMPRA for the first time. For others who are AMPRA members, it is time once again to renew your membership in your AMP/Tyco Electronics retiree’s organization. The requested minimum contribution – thanks to your loyal support – remains at $10 and covers the period January 1st to December 31st. Your contribution includes membership for your spouse and entitles that spouse to participate in any programs and/or benefits offered by the organization. It is not necessary to contribute another $10 for your spouse unless he/she would like to receive a personal copy of our quarterly News and Notes publication.
Renewal forms and checks should be received by AMPRA no later than January 1st in order to ensure continuous receipt of the News and Notes. It is important that you fill out the form below in its entirety to help us maintain accurate mailing records. The Post Office computers require this information from us and we need your help in keeping it up-to-date.
Your AMPRA Board asks your help in growing our organization. Please remember to invite any of your former co-workers to join. You may photocopy this request , copy the one on the website (www.ampra.net), or contact any Board member and request that one be mailed.
Membership is open to retirees, as well as all former AMP and Tyco Electronics employees interested in keeping in touch and taking advantage of our trips, social functions and benefit programs. Current Tyco Electronics employees are not eligible. Former employees of Amp and Tyco Electronics are eligible even if they are not retired and are perhaps working somewhere else. There is no age restriction to become a member. Spouses of deceased former employees are welcome to remain a member.
Trips and events are open to members and also open to any one interested in attending.
Thank you for your continuing support and participation in our activities!
Retiree's Name: ________________________________________
Spouse's Name: ________________________________________
Street Address: _________________________________________
City: _____________________ State: _____ ZIP Code: __________
Telephone: ( ) ___________________
Email Address: _________________________________________
Amount Remitted:
Dues @ $10 per member: __________
Additional Contribution, if any: ___________
Total Amount Remitted: ________
Check Number: _________
___ Check if two copies of "News & Notes" are requested
(addtl. $10 contribution required)
___ Check if you no longer wish to receive an annual mailing from AMPRA
Signature: _____________________________________________________