Name: Callsign:
ARRL member? Yes No Membership type: New Renewal
Family members at same address wishing to join FARA:
Street address:
City/town: State/province: Zip code:
Telephone: E-mail address:
Membership type: Regular, $15 (Jan. 1 - Dec. 31) Student, $10 Senior Citizen, $10
FARA repeater membership (optional support of our repeaters), $10
Do you want your monthly newsletter by e-mail or postal mail
Can we publish your: address in the club roster? Yes No telephone number in the club roster? Yes No
Any additional questions or comments:
Thanks for your application to join FARA!