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  NEFE Request Form  
         
 

NAME

 

Are you a UECU Member?

 
     
         
 

SCHOOL NAME

     
       
         
 

SCHOOL ADDRESS

 

CITY

 
     
         
 

ST

ZIP         

 

SCHOOL PHONE NUMBER (only numbers)

 
 
   
         
 

 
 

 
         
 

E-MAIL ADDRESS

     
   
 
Once your form is submitted, we will send you an automatic reply to your email address.
 
         
 

COMMENTS/QUESTIONS