Please print and complete this application and mail it along with your check for $60 (or $50 if you are already a member). Money collected will be used in our efforts to retain counsel and cover necessary expenses of committee work. No money collected will ever be used to pay members of the DALRC Board of Trustees for their time.Send your application to:
DALRC
544 Wood Creek Rd
Williamson GA 30292
status: active ___ retired___ spouse___ survivor___ former employee___
date hired: __________ date retired: __________
current/last dept. name or number: ________________ and station ____
e-mail address: _________________________________
Should it ever become necessary to seek representation in bankruptcy court to protect
my Delta benefits, I hereby give my proxy to the Officers of DALRC to vote for the
formation of a creditor's committee and hereby authorize the Officers to serve as my
authorized representative on the committee. (Note: This proxy can be withdrawn at any
time with written notification to DALRC at its current address.)
signature ____________________________________ date_______________ (Pilots, please see the DP3 website or contact them for more information regarding your organization.)
