Join the Peralta Retirees Organization

Please enter the information in the form below. After you complete the form:

  • Print the page
  • Decide if you wish to join for:

    • 1 Year - $20
    • 3 Years - $55
    • 5 Years - $80
    • Lifetime - $250

  • Mail the printed page and a check made out to "PRO" for your dues to:

    PRO
    1250-I Newell Avenue, #162
    Walnut Creek, CA 94596

Name

Address

City, State, Zip

Email

Phone

Which health plan are you a member of?
CoreSource Traditional
CoreSource Light
Kaiser

Are you enrolled in Medicare?
Yes
No

Indicate any contact information that you would like included in the PRO Member Directory:
Your address Yes No
Your phone number Yes No
Your email address Yes No

Unless you authorize PRO to list contact information in the Member Directory, no contact information for you will be available on the PRO website. The Member Directory is password protected. To obtain the password, email a request to:
webmaster@peraltaretirees.org.

 

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