2010 On-Line Membership Application

This application is a: New Membership Membership Renewal

Call Sign: License Class:

*First Name: *Last Name:

*Street Address: *City: *State: *Zip:

*County in which you live:

Home Phone: Cell Phone: *E-Mail Address:

Phone and E-mail information published in PARA roster? Yes No

Would you like a PARA Membership Card mailed to you? Yes No

Are you a member of: ARRL ARES RACES

Membership is free, but an annual donation of $15 is suggested. PARA operates three amateur radio repeaters, an EchoLink node, and has several large projects planned for 2010. Donations for these projects, or general operating expenses, are appreciated but not required.

*=Required Item






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