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APPLICATION FORM

PDF available print & return to  EARA, 700 S. ROYAL POINCIANA BLVD., SUITE 501, Miami Springs, FL 33166

ANY FORMER EAL EMPLOYEE CAN JOIN EARA,

EASTERN AIRLINES RETIREES ASSOC.

PLEASE CHECK ONE BOX

ASSOCIATE

NEW MEMBER

 RENEWAL
 

last name

  

first name

  

middle initial

  

nickname

  

maiden name
street or PO Box Spouse Name
city state zip
phones Home website or E-mail address
Work fax
Birthdate, Month and Year Last EAL position worked
EAL Employee Number Last EAL base
Do you have a paid job? Your current job location and position

POSTAGE OPTIONS PER YEAR, Check one please
Option 1, US Possessions, Puerto Rico, Virgin Islands, First Class $9.00 per year Option 2, optional, standard mail, no extra charge Option 3, Canada 1st class $11.00 Option 4, all others worldwide, $20.00

PLEASE ADD APPROPRIATE POSTAGE TO YOUR DUES!  THANKS!
Dues $25 per person, per year amount enclosed
Dues $40 per person, two years amount enclosed

(Add appropriate postage -- above is for a single year -- multiply x 2)

 EXTRA DONATION ENCLOSED $__________________ Include this in your check.

Does this include a second membership for your spouse? YES NO

 (This Is Not Tax Deductible) Checks payable to “EARA”
If YES, Include spouse’s birthdate Month________ Date ________

* If you are receiving a retirement payment from PBGC or Prudential,

PASS PRIVILIDGES FOR EARA

 Call EARA for Forms 305-884-6132

CONTACT DAN BLYTH FOR THOSE LISTED BELOW (1-800-266-6738 )

• British Airway• Delta • Frontier • Icelandair • JetBlue • Martinair • Midwest • Quantas • So. Africian Airways • Southwest • Sun Country • US Airways • Virgin Atlantic

For Cayman Airways: Direct 305-266-6760, ext. 8650  

For Spirit: Contact Corrine @ 305-884-6132

For Gulfstream: Direct (954) 985-1500 . ext. 243

Widows/Widowers DO HAVE Pass Privileges IF THEY BELONG TO EARA
MAIL TO: EARA, 700 S. ROYAL POINCIANA BLVD., SUITE 501, Miami Springs, FL 33166
Would you be willing to do volunteer work with EARA?   YES     NO Widows/Widowers DO HAVE Pass Privileges IF THEY BELONG TO EARA