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

Membership Application...............     New Member_____ Renewal_____
Hiawatha Amateur Radio Association of Marquette County, Inc.
P.O. Box 1183
Marquette, Michigan 49855

Name:______________________________________________ Callsign:___________________
Address:___________________________________________ License Class:______________
City:____________________________ State:_____ Zip:_______ Phone ________________

Today's date:________________   Date of Birth:________________   ARRL Member?:  Yes___ No___
Email address:__________________________________________________

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, $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.  (Family members must reside in the same household.)  Our club year starts on September 1st and ends August 31st.
FOR NEW MEMBERS ONLY, dues paid before May 1st will expire on August 31st of the same year, with dues paid after May 1st your membership will be good until August 31st of the following year.
(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.


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