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
315 Snider Dr
Walla Walla, WA 99362-8078