Application for Membership

Please complete the following application and someone will contact you.

* Name:

* Call Sign:

* Street:

* City:	* State:	* Zip Code:

Sponsor:

Phone:

E-Mail Address:

Operator Class:

Radio Interests:

* Required fields

How would you like to be contacted?
Please give me a phone call.
Please respond through Postal Service.
Please respond through E-mail.

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