Name____________________________  Call_____________  Year First Licensed _________

         License Class______,  ARRL [  ] Yes  [  ] No,   E-mail______________________________

Name____________________________  Call_____________  Year First Licensed _________

         License Class______,  ARRL [  ] Yes  [  ] No,   E-mail______________________________

Name____________________________  Call_____________  Year First Licensed _________

         License Class______,  ARRL [  ] Yes  [  ] No,   E-mail______________________________

Name____________________________  Call_____________  Year First Licensed _________

        License Class______,  ARRL [  ] Yes  [  ] No,   E-mail______________________________

Street Address_______________________________________________________________

City, State, ZIP ______________________________________________________________

 Phone  _________________

   Alternate Seasonal Address (for months of ___________________________):

Street Address_______________________________________________________________

City, State, ZIP ______________________________________________________________

Membership:  [  ] Individual  $12.00     [  ]  Family  $15.00      Today's Date __________________
                      (Membership year runs Jan - Dec)
 

Mail to:  McDowell Amateur Radio Association
              P.O. Box 520
              Marion, NC   28752                                                                   Rev  1/08