MARIN AMATEUR RADIO SOCIETY
P.O. BOX 6423
SAN RAFAEL, CA 94903-0423

MEMBERSHIP APPLICATION FORM

Annual Dues: Regular-$25; Family-$30
Please make checks payable to MARS

Primary Member:
First Name
Last Name
Middle Initial
Ham Call
License Class
Address
City
State
Zip
Phone
FAX
Email
ARRL Member?
You may list my phone number on-line
You may list my email address on-line
Spouse Name

Second Member (Family Membership):
First Name
Last Name
Middle Initial
Ham Call
License Class
Address
City
State
Zip
Phone
FAX
Email
ARRL Member?
You may list my phone number on-line
You may list my email address on-line

Amateur Radio Interests (check applicable):

Primary Member      Second Member
On-air rag-chewing (HF VHF/UHF ) On-air ragchewing (HF VHF/UHF )
DX chasing DX chasing
Packet communications  Packet communications
Satellite communications Satellite communications
Field activities (e.g., Field Day, T-hunts) Field activities (e.g., Field Day, T-hunts)
Emergency preparedness/RACES Emergency preparedness/RACES
Morse Code practice/License upgrading Morse Code practice/License upgrading
Equipment construction projects Equipment construction projects
SWL (short wave listening) SWL (short wave listening)

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  updated 10/28/2008