Texas State Retired Faculty and Staff Association
Texas State Retired Faculty and Staff Association
Membership Form
RFSA does not charge membership dues.
____________________________ ___________________ ______ ___________
Retiree's Last Name First Name MI Title
Are you a Veteran? ____ Yes ____ No
____________________________ ____________________ ______ ___________
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
___________________________________ ____________________ ______ ____________
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 ___No Exercise/Health? ___Yes ___No
An annual social event? ___Yes ___No Investments? ___Yes ___No
Lectures and/or programs? ___Yes ___No Books? ___Yes ___No
Travel in- or out-of-state? ___Yes ___No Bridge? ___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
and the Petty Cash 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 executes the 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 and assists in
selecting materials for the University Archives.
_____ Program Committee -- Plans and organizes social events such as luncheons, pre-game socials 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 914, Texas State University, San Marcos, TX 78666
Modified: September 23, 2014
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