Date__________________________ New____________Renewal____________

FULL MEMBERSHIP: $12 a year for a licensed amateur, full privileges, which allows you to vote, hold an office, and grumble if you want to. Optional 5 years for $50

ASSOCIATE MEMBERSHIP: $7.50 a year, non licensed, does not allow you to vote or hold office, allows you to grumble but does not guarantee anyone will listen very long.

Membership year is from March 1^st till March 1^st  each year. Anyone not renewing by May 1^st each year will have their names removed from the membership roll.

Anyone joining after September 1^st will pay Half Price for membership, which will cover remaining months until the following March 1^st annual renewal.

Fill out application (please print)                                                           

Name ______________________________ Call __________ Lic. Class ________

Street Address  (Or PO Box)___________________________________________

City _______________________________  State __________ Zip _____________

Phone (_____) _________________ Email ________________________________

Other hobbies or interests _____________________________________________

Preferred ham activities _______________________________________________

___________________________________________________________________

Application Date:  _______________   Date Application Approved: ____________

Dues Enclosed:   CASH ___________  CHECK ___________ MO_____________