Texas State Retired Faculty and Staff Association

Texas State Retired Faculty and Staff Association

Membership Form

RFSA does not charge membership dues.

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Retiree's Last NameFirst Name MITitle

Are you a Veteran? ______

______

Spouse or Partner's Last Name First Name MI Title

Are you the surviving spouse or partner of a retiree? _____Yes _____No

Do you or your spouse or partner desire an individual membership? _____Yes _____No

______

Department or Office Year Employed Year Retired

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Mailing Address City State Zip Code

______(______) ______- ______

Email Address (Please Print Clearly) Preferred Telephone Number

We will use your email address as our primary source for communicating periodic updates, invitations to special events and other items of interest to retirees.

May we publish your email address on our website? _____Yes ______No

What kinds of activities might interest you? Please check all areas of interest.

Monthly or quarterly luncheons? ___Yes ___NoExercise/Health? ___Yes ___No

An annual social event?___Yes ___NoInvestments? ___Yes ___No

Lectures and/or programs?___Yes ___NoBooks? ___Yes ___No

Travel in- or out-of-state?___Yes ___NoBridge? ___Yes ___No

Other ideas?______

Would you like to serve on the RFSA Advisory Board?___Yes ___No

Would you like to serve on any of the RFSA Committees?___Yes ___No (check committees listed below)

_____Annual Meeting and Nominating Committee – Secures a slate of officers for presentation at the

Annual Meeting in April. Determines the venue, date and time, and program for the Annual Meeting.

_____ Budget Committee – Tracks expenses and reports monthly the balances in the University Account

andthe PettyCash Fund.

_____ Care Committee – Provides assistance to university retirees and their families in times of

need. Includes sending get well or sympathy cards, home or facility visitation, meal assistance, or other needs as requested by the families.

_____ Fall Social Planning Committee -- Plans and executesthe fall event for retirees to get together

for food, social time, to announce the new scholarship recipients and to raise additional funds for the Association and next year’s scholarship awards.

_____Historical Committee -- Maintains the Association’s historical records and exhibits andassists in

selecting materials for the University Archives.

_____Program Committee -- Plans and organizes social events such as luncheons, pre-gamesocials for

athletic events, trips, and the holiday social.

_____Scholarship Committee -- Makes recommendations regarding the number and dollar amount for

annual scholarship awards, advertises for scholarship applicants with assistance from the University Liaison, and keeps the application and MOU in compliance with Texas State requirements.

Return this Membership Form to:Retired Faculty and Staff Association, c/o University Advancement, 601 University Drive, JCK 480, Texas State University, San Marcos, TX 78666

Modified: September 23, 2014