From the Upper Peninsula of Michigan along the southern shore of Lake Superior ~ Station  K 8 L O D

Membership Application...............New Member_____ Renewal_____        DATE: ______________

Hiawatha Amateur Radio Association of Marquette County, Inc.
P.O. Box 1183
Marquette, Michigan 49855                                                HARA Website:

Name:______________________________________________ Callsign:___________________
Address:___________________________________________ License Class:______________
City:____________________________ State:_____ Zip:_______ Phone ________________
Email address:__________________________________________________
(our monthly newsletter and other club announcements are emailed via Bcc:)

Birth Month:________________ ARRL Member?:Yes___ No___

To become a full member you must be a licensed amateur and a resident of Marquette County (MI). If you do not
qualify for full membership, you can join as an associate member. Associate members do not have voting
privileges. Club dues are $15 per individual, $20 for family memberships, Family members must reside in the
same household, $10 for associate membership and $15 for family associate membership. A full-time student
under the age of twenty-five membership is also available at $7.50. Our club year starts on September 1st and
ends August 31st.

(Membership renewal must be paid up prior to the annual election of officers meeting in October if you wish
to vote in said election.)

Please check type of membership desired:                                   
___ Individual Full membership......$15/yr.
___ Family Full membership......$20.yr.
___ Associate membership...$10/yr.
___ Associate family membership...$15/yr.
___ Student membership...$7.50/yr.

Family Membership, list family members and callsigns:

It is not necessary to complete the rest of this form. The following information may be used as your
introduction to our club members in our newsletter.

Single ____ Married ____, Spouse's name and callsign (if Licensed):___________________

Briefly describe you rig(s) and antennas:________________________________

Favorite ham activities: (Check as many as you wish)
Nets ____ Contests ____ Ragchewing ____ DX'ing ____ RTTY ____ Amtor ____ Packet ____ CW ____
ATV ____ Repeaters ____ Satellite ____ Field Day ____ ARES/RACES ____
Public Service Events ______________________
Please print and mail this form with the appropriate dues to the address above. Thank you.
Download Word Version.


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