TCARA

Tri-County Amateur Radio Assoc.

P.O. Box 75, Claremont, CA 91711 USA

MEMBERSHIP APPLICATION

(Use the TAB key to go from field to field)

Send your check to the above address payable to TCARA.
If preferred, print this form, fill-in, and snail mail it.
When we receive your check, you will be a member!
Welcome!

Date____________

(If you have one)
First Name: Last:
St.Address:
City: State: Zip: Phone:

License Class:
Novice Tech. Tech Plus General Advanced Extra None

Email address:

Birth Date: (MMDDYYYY, Optional)

Member of:ARRL AREC RACES MARS

Other Interests:
DX VHF HF CW RTTY Computers Internet Contests

Dues per year:$15 Single $20 Family Renewal New Member

If this is a Family Membership, please prepare another application for each family member.
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