LLRA Membership Application Form
You may submit your membership electronically via the this form.
If your spouse retired from LLNL as well, please fill out a separate form for your spouse.
Please write to email@example.com
if you do not receive an email confirmation within a few minutes after you submit your form.
If you prefer to submit a form by mail, you can use the download button below to obtain a printable form.
NOTE: Livermore Laboratory Retirees Association (LLRA) is not sponsored by or affiliated with Livermore Laboratory Employee Services Association (LLESA) Inc. or Lawrence Livermore National Laboratory (LLNL).