Membership Application...............New Member_____ Renewal_____ DATE: ______________
 
Hiawatha Amateur Radio Association of Marquette County, Inc.
P.O. Box 1183
Marquette, Michigan 49855
 
HARA Website: http://www.qsl.net/k8lod/
 
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:
1:____________________________________________________
2:____________________________________________________
3:____________________________________________________
4:____________________________________________________
 
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.
 
Occupation:_______________________________________________________________________
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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