NERA Update Info Form
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1. N.E.R.A Change of Information Form
*
1
. Mailing Address
Mailing Address
Name:
Street Address:
City:
State:
Zip Code
2
. Phone Number:
Phone Number:
3
. Email Address:
Email Address:
4
. Preferred Method of Contact:
Preferred Method of Contact:
Snail Mail
Phone
Email
I would rather not be contacted.
5
. What would make N.E.R.A a more appealing organization? What do you wish it could offer as member benefits?
What would make N.E.R.A a more appealing organization? What do you wish it could offer as member benefits?
6
. Would you be willing to help make your suggestions a reality?
Would you be willing to help make your suggestions a reality?
Yes
No
7
. Would you like to contibute your talents to the growth of the organization and/or with regional events?
Would you like to contibute your talents to the growth of the organization and/or with regional events?
Yes
No
8
. If yes, what areas would you be most interested in?
If yes, what areas would you be most interested in?
Public Relations/Promotions
Technology Assistance
Event Planning
Graphic Design
Event On-Site Assistance
Workshop Presenter
Other (please specify)
9
. Additional Comments:
Additional Comments:
Thank you for taking the time to update your information and share your thoughts with us!
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