Name New Membership or Renewal? * New Member Renewal Callsign * License Class * None Novice Technician General Advanced Extra First Year Licensed and Callsign First Name * MI * Last Name * Date of Birth * Street Address * Apt# City * State * - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Home Phone Mobile Phone Email Address Occupation Spouses' Name Spouses' Occupation ARRL Member? YES NO ARES or RACES Appointee? YES NO What are your areas of interest/expertise? How did you hear about our club? Select Membership * Full Individual (Licensed) $15/yr Associate (Non-Licensed) $7.50/yr Family $15/yr + $7.50yr each family member Licensed members have voting rights and are considered "Full Individual" members. Those who do NOT want voting rights or not licensed are considered "Associate" members. Membership Total Total:$ Please attend the next meeting and remember to bring your membership dues. You can pay via PayPal, check or cash.