San Diego Repeater Association
P.O. Box 81103
San Diego, CA. 92138

On-Line Membership Application 

Make A Secure On-Line Payment With PayPal,* (see below), or mail membership application
to the above address. Click HERE for the printable form, or complete and e-mail the form below.

(SANDRA dues are $20.00 a year per household)

	Please Select: New Membership Renewal Expired Membership Update Member information Donation
1. Your Amateur Call Sign:	2. License Class: Novice Technician General Advanced Extra
3. Last Name:	4. First Name:
5. Previous Call Sign:	6. When does your  License Expire?
7. Please give your address which we can send our newsletter STREET: CITY:       State: ZIP CODE(+4):  Country:
8. E-Mail Address (Mandatory):
9. Home Phone Number:	10. Work Phone (Optional):
May we publish you number in the membership roster? YES NO
11.  Check here if you are a member of the ARRL.	12.  Check here if you are a member of ARES.
13.  Check here if you are a member of RACES.	14. Other Interests:
15.a. Family Membership : (Spouse) Name:  Call Sign (if any) License Class  None Novice Technician General Advanced Extra	15.b. Child 1 (Same Residence as Primary Member) Name:  Call Sign (if any) License Class  None Novice Technician General Advanced Extra
15.c. Child 2 (Same Residence as Primary Member) Name:  Call Sign (if any) License Class  None Novice Technician General Advanced Extra	15.d. Child 3 (Same Residence as Primary Member) Name:  Call Sign (if any)  License Class  None Novice Technician General Advanced Extra
If paying by check, make it payable to: SANDRA, INC.  For new membership and renewal:  $20.00 for individual or family membership.  No initiation fee. Please note on the check the day this form was submitted. Any questions, please call (888) 683-8233. SANDRA, Inc. is a Non-Profit 501(c)(3) Organization