Retiree Contact Information

Would you like to receive e-mail communications from Dow?

By completing and submitting this electronic form, you are authorizing Dow to send you via e-mail the communications you select below. You will only receive the types of communications you select, and you may unsubscribe from any of these communications at any time by simply returning to this form and updating your preferences.

You may also return to this form to update your e-mail address and/or other personal information, and/or subscribe to additional communications.

Your personal information will be used for the stated purposes only and will not be sold nor provided to anyone else without your permission. Please note that this form does not replace Dow's Change of Address form.

Already registered? Need to update your contact information and/or preferences?
Please enter your registered Email Address in the box below and click "Login."

Registered E-mail Address

Signing up for the first time? Please complete the information below and click "Submit."

Preferences

Please select "Yes" for each type of communication you wish to receive.
(You may return to this form at any time to update your selections.)

Yes, I would like to receive an electronic version of the DowFriends retiree newsletter. By agreeing to receive the DowFriends newsletter electronically, I understand that I will no longer receive it by mail. I can download the newsletter at www.dowfriends.com if I want a printed copy.

Remove me from the DowFriends electronic newsletter distribution.

Yes, I would like to receive periodic news and information from Dow via e-mail.

Yes, I would like to receive the Retiree Health E-News.

Remove me from e-mail distribution of Dow news and information.

Yes, I would like to learn more about Dow and Union Carbide retiree groups. Please release my information to them so they may contact me. (Note that these retiree groups are not part of The Dow Chemical Company or Union Carbide Corporation and are organized as separate legal entities.)

Personal Information

Please check:

	I am a Dow retiree.
	I am a Rohm and Haas retiree.
	I am a Union Carbide retiree.

First Name^‡

Last Name^‡

Dow 6-digit ID number (preceding 'U' is not required) ^‡
If you do not have a Dow ID number, please enter "N/A."
DO NOT enter your Social Security Number or your former UCC or Rohm and Haas ID number.

E-mail Address^‡

Street Address^‡
Should contain only alphabetic and numeric characters.
Use No. in place of # in the address field.

City^‡

State (US Only)

Zip^‡

Country^‡

Phone^‡

(Include Country/Area Code)

Year Retired from Dow/UCC/ROH^‡

Last Location Worked^‡

Enter the code as it is shown (required):

^‡ Required Field

Data Privacy and Protection

The information collected in this form will only be used to ensure that we provide you with an appropriate response based upon the information you provide in the form above. We will contact you only if we need additional information to appropriately answer your question or in order to address your need. The contact information you provide, including e-mail address, may be used to respond to your request. We will not use the contact information you provide in this form for product or promotional advertising unless you specifically request to receive product news or information.

For more information, please review our Privacy Policy.