The Quarter Century Club induction luncheon honors employees who have achieved 25 years of service with MIT.
Quarter Century Club T: 617-253-7914 F: 617-253-8006 qcc-reply@mit.edu
Mailing address 77 Massachusetts Avenue MIT Room E38-234 Cambridge, MA 02139
Member Name:
Former Department:
Address:
Telephone number/Email:
Date of retirement:
Are you a first-time applicant: Yes No
Will you receive funding from any other source(s): Yes No
Course, program, or instruction description Please identify and describe the course, program, or instruction you plan to take, times and dates it meets and any other related information. If you have additional information to include such as pamphlets or handouts, please send them to the Community Services Office (mailing address is available in the sidebar).
Cost of Course:
Name and address of the institution or organization you plan to attend; or provide the instructor's name and his/her professional affiliations & credentials:
Course, program, or instruction evaluation Appliants are required to provide a summary of the course experience in order to receive reimbursement.
Following completion of the course, I agree to provide a written summary of the course and a description of the skills I learned and/or benefits and results achieved.
Electronic Signature: Date:
The Quarter Century Club induction luncheon honors employees who have achieved 25 years of service with MIT.
