LLRA Membership Application Form

You may submit your membership electronically via this form.

If your spouse retired from LLNL as well, please fill out a separate form for your spouse.

Please write to chair@livermorelabretiree.org

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).

Livermore Laboratory Retirees Association

P.O. Box 2170, Livermore, CA 94551

info@livermorelabretirees.org | Tel: 925-443-9092

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