Membership Application

Keeping and improving your retirement, health and other benefits is RELAC’s most important mission! To do that we must show that RELAC represents a significant portion of L.A. County retirees. If new retirees fail to join RELAC, our influence may diminish.

RELAC needs your help in recruiting new members. Check with your L.A. County retiree friends to see if they have joined. If you have friends who are still working, let them know that they can join as affiliate members and receive the RELAC Newsletter and participate in our activities.

REMEMBER – while LACERA, the Board of Retirement, County unions, the County Board of Supervisors and the State Legislature all have interest in your well-being, they all have to deal with other interests competing with your interests. Only RELAC is exclusively interested in protecting and improving your benefits.

"*" indicates required fields

Please fill out the form below to join RELAC. If you prefer to download the form to print and mail via USPS, please click here.

This form requires cookies, please make sure you are not blocking cookies for this site or the form may not work correctly!

Name*

Address*

Date of Birth*

Last 4 digits of SSN*

Phone*

E-mail*

Gender:*

Male

Female

County Dept. Retired from:*

Retirement Date*

Select Your Membership Type:*

Retiree Only ($5.00/Month)

Retiree & Spouse/Partner ($7.00/Month)

NOTE: If spouse/partner is also a County retiree, (s)he must also join as a retiree member (two memberships = $10/month).

Spouse Name*

Spouses Birthday*

Authorization

I authorize LACERA to deduct my monthly dues from my retirement check and pay that amount to RELAC.

RELAC E-mails

Keep me posted - I want to receive periodic RELAC e-mails and notices concerning topics of importance to me.

Save paper - I want to receive the RELAC newsletter by e-mail only.

How did you hear about RELAC?

Menu

We’re on Facebook

Contact RELAC

Send Us Feedback