This survey is intended to allow the retired members committee to capture the details of existing and new retired members .

The data collected will be for the sole use of the POA retired members committee and will not be shared with third parties.

If you are a retired member, please complete the survey.

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* 1. Retired Member's Name

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* 3. Retired Member's telephone number

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* 4. What was the name of your last establishment?

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* 6. What was the date of your retirement

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* 7. I have read and consent to the POAs privacy policy

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