Northwest Adventist Amateur Radio Association

Membership Application

 

Date:__________________________________

Name:   ________________________________   Call:   _____________   License Class:  ______________

Spouse:   _______________________________   Call:   _____________   License Class:  ______________

Child/Age:    _____________________________   Call:   _____________   License Class:  ______________

Child/Age:    _____________________________   Call:   _____________   License Class:  ______________

Child/Age:    _____________________________   Call:   _____________   License Class:  ______________

Child/Age:    _____________________________   Call:   _____________   License Class:  ______________

(NAARA welcomes full-time students as members with no annual dues!)

Address:   _____________________________________________________  Phone:  _____-_____-_______

City:  _______________________________________   State/Prov: _______  Zip/Postal:   _______________

Street address if above is PO Box #:   ________________________________________________________

E-Mail Address:     ________________________________________________________________________

Phone number:     ________________________________________________________________________

Band(s) on which you operate:     ____________________________________________________________

 

Dues: $10/year + $2/additional family member ----------------------------------------------------------à                    =                                                                                                                                    $________

 

Mail completed form with check (made out to NAARA) to:    Keith Carlin

                                                                                                24113 SE Green Valley Rd.

                                                                                                Auburn, WA 98092-1258