Update Personal Information

This form allows EXISTING MEMBERS to update membership information. NEW MEMBERS should choose an option from the JOIN menu above!

Old Email address :
(used to identify record to change)

First Name:

Last Name:

Maiden Name (or N/A):

Address:

State:

City:

Zip Code:

Telephone:

Email address:

Employer:

Title:

Update Membership Info. - Page 2

Professional Education:

School

City, State

Degree/Cert.

Year

Professional Organizations of which you are a member:

Specialty/Practice Area:

Special Interest/Knowledge Area:

Update Membership Info.

Are you willing to:

Speak to individuals

Speak to small groups

Speak to large groups

Speak to news media

Do you wish to become involved
with one of the chapter committees?

Membership:

Public Relations:

Newsletter:

Program Committee:

Eastern Mass. NAPNAP shares this information with our membership through a Resource Directory.
Check this box if you do not wish to share this information in our directory.

Thank You for your Update

We will contact you soon via your old and new email addresses to verify that you have initiated this request. Once we receive confirmation, your personal information will be updated as you request.