Emeritus Self-Nomination
First Name:  (Required)
Last Name:  (Required)
Email:  (Required)

First Name  (Required)
Last Name  (Required)
Email Address  (Required)
Phone Area Code  (Required)
Phone  (Required)
I have retired (Check "yes" if you have formally terminated regular professional employment through retirement. Only retired members are eligible for emeritus membership in NEAIR.)
I am a current member of NEAIR (Check "yes" if you are a current member of NEAIR at the time of retirement. This current membership status is also a requirement for Emeritus Membership.)
I have 7 years of membership (Check "yes" if you have been an active member of the Association for a minimum cumulative total of seven years. These do not need to be consecutive years.)
Years of membership (Please indicate the years you were a member of NEAIR.)  (Required)

Activity (Please briefly describe your active role in NEAIR.)

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