TORKS Member Online Change of Address

NAME

 Required

 NEW ADDRESS

 Required

 CITY

 Required

 STATE

 ZIP

  

Required

PHONE #

 ###-###-#### Required

AMA #

 Required

EMAIL ADDRESS
(Leave empty if you don't have email)

Optional

OTHER COMMENTS

   Optional
 
INSTRUCTIONS

Fill out all the required information and press the submit button. Pressing the submit button automatically sends the information to the treasurer via email. A window listing the information being sent will appear. Close the window and the home page will be re-displayed.

The TORKS Treasurer will send confirmation of receipt of application if a valid and active email address has been provided. Please allow 48 hours for processing.