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To join RPEA, complete the online membership form and submit payment securely online.

Name*
First Last
Email*
Phone*
Address*
Street Address City State ZIP Code
Name of spouse/domestic partner who will receive free membership
First Last
I am retired from*
Did someone recommend RPEA to you?*
- Yes
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If so, who?
How you heard of us*
- Mailer
- Friend/Referral
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Other
Membership Dues*
Payment Information*
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Card Number Expiration Date Security Code Cardholder Name

Sign up today to enjoy the benefits of RPEA!

Join numerous other public retirees who take advantage of our benefits every day.

RPEA, Inc.
165 Jordan Rd., Troy, NY 12180
(518) 869-2542
(800) 726-7732
mail@rpea.org

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