BULLETIN TO BE MAILED  ONLY ON REQUEST

    The print edition of The Bulletin will be mailed to retirees ONLY upon request.  Names will be removed from the mailing list unless a request is received by August 1, 2004.

Mail the form below to :

Brookhaven National Laboratory
Attn: The Bulletin
Bldg 134 P. O. Box 5000
Upton, NY 11973-5000

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YES,  I WANT THE BULLETIN MAILED TO ME.

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NAME

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ADDRESS LINE 1

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ADDRESS LINE  2

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CITY                                                         STATE                      ZIP

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EMAIL ADDRESS

Form Posted on BREA Web Page June 30, 2004
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