Membership Information First Name *Last Name *City *State/Province *ZIP / Postal CodeEmail Address *Home PhoneCell PhoneAre you licensed? *NoYesFCC License DataCall Sign *License PrivilegesTechnicianGeneralAdvancedExtraExpiration DateFCC Database – Copy and Paste URL in browser to see license datahttps://wireless2.fcc.gov/UlsApp/UlsSearch/searchLicense.jspAre you an ARRL Member?NoYesARRL Membership DataARRL Member TypeAnnualLifeExpiration DateFamily MemberAdd Family MemberFamily member must live at your address.First Name *Last Name *Email Address *PhoneIs the Family Member LicensedNoYesFCC License Data – Family MemberCall Sign *License PrivilegesTechnicianGeneralAdvancedExtraExpiration DateMembership Payment OptionsMembership TypeNone – Donation OnlyYearlyLifeAnnual Membership$20.00 yearly. Good for the calendar year in which payment was received. Payments recieved in November and December covers following year as well.Life Membership TypeStandard – $400Senior – $200Payment OptionsOne time – Full amountQuarterly – 1/4 Initially. The rest quarterly.Time paymentInitial PaymentFollow-On PaymentDonations are made in the next stepMake a Donation to the club?YesGeneralUSDRepeater EndowmentUSDChristmas PartyUSDTotal Donation AmountTotal AmountSend Message
