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Name:___________________________________Call:____________
Address:_________________________________________________
City:________________________
State:_______ Zip:____________
Phone:( _____)________________ Birthdate:___________________
License Class:_____Expiration Date:_________ ARRL Member:____
Signature: ______________________________ Date:____________
E-Mail address:
____________________________________________
***Do not complete this section- for Membership Chairman only.***
Amount $_______Check #________ Taken By:_____ Date:________
LCARA membership is annual (Jan. 1 to Dec. 31) only. $10 per year,
pro-rated at $2.50 per quarter remaining in the calendar year for new
members. Additional family members at same address, $3.00 flat rate for new
or renewals. Associates non-prorated $7.50/year.
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