Telecom Pioneers Chapter 139
Life Member Club
Questionnaire - April 2004

We appreciate your time in answering this questionnaire.  If you submit this online there is no need to send in the paper questionnaire.  Asterisk indicates required field.  If your form gets rejected due to validation, use the back arrow on your browser to get back to the form.  This way, you won't lose the answers you already put in.

      *First Name 
       *Last Name 
   Middle Initial 
  HR id (if known)
  *Street Address 
  Address (cont.) 
            *City 
           *State 
        *Zip Code 
            Phone 
          E-mail 
1.  Are you interested in becoming involved in some of our volunteer projects?
Yes.  I'm interested.  Please keep me in the loop about upcoming opportunities.
No.  I'm really not interested.
2.  Are you interested in attending our luncheons that are held throughout the year?
Yes.  I'm interested.  Please keep me in the loop about upcoming opportunities.
No.  I'm really not interested.
3.  Are you interested in reading the "Life Member Times" newsletter?
Yes.  I'm interested.  Please send me a paper copy.
Yes.  I'm interested.  I will get my copy from the AT&T NJ Pioneer website (www.attnjpioneers.org).
No.  I'm not interested.
4.  What is the best way for us to communicate with you?
Email, I read my email on a regular basis.
Phone calls work best for me.
U.S. Postal Service.
5.  Would you like us to post your name and email address on the Life Members Online Directory?
Yes.
No.