2022 Membership Form
OXNARD UNION HIGH SCHOOL DISTRICT RETIREE's ASSOCIATION
PO BOX 7195
OXNARD, CA 93031
WEBSITE: ouhsdra.com
Name_____________________________________________
Position when retired_________________________________
Site when retired_____________________________________
Do you have a spouse/partner covered by your benefits? ______Yes _______NO
Name of person covered_________________________
Email ______________________________________
Mailing address___________________________________________________
Phone number______________________________
WE KEEP YOUR PERSONAL INFORMATION CONFIDENTIAL
If you know of any OUHSD retirees please provide contact information_________________________________
Please mail this membership form to: OUHSDRA, PO BOX 7195, Oxnard, CA 03031
Voluntary dues are $10.00 a year or $100 lifetime
OXNARD UNION HIGH SCHOOL DISTRICT RETIREE's ASSOCIATION
PO BOX 7195
OXNARD, CA 93031
WEBSITE: ouhsdra.com
Name_____________________________________________
Position when retired_________________________________
Site when retired_____________________________________
Do you have a spouse/partner covered by your benefits? ______Yes _______NO
Name of person covered_________________________
Email ______________________________________
Mailing address___________________________________________________
Phone number______________________________
WE KEEP YOUR PERSONAL INFORMATION CONFIDENTIAL
If you know of any OUHSD retirees please provide contact information_________________________________
Please mail this membership form to: OUHSDRA, PO BOX 7195, Oxnard, CA 03031
Voluntary dues are $10.00 a year or $100 lifetime
