Application for MTARS Membership

Rev: 7 02/29/2024

Application for MTARS Membership

OFFICE USE

Today’s Date:_____________ ; Membership year: _________ ________

Dues for membership in the Middle Tennessee Amateur Radio Society are: ________

CIRCLE MEMBERSHIP TYPE 1-4 ________

(1) $20 per year for Regular (voting) members _________

(2) $30 per year for Family living in _________

“Same Household Only”! _________

(3) $00 Free for Junior’s _________

(under age 17, (non-voting members) _________

(4) $20 per year for Associate _________

(non-voting or not licensed) _________

_________

An amateur license is required ONLY for regular, voting members. _________

Print and fill out this application and mail it along with a

Check in the proper amount to:

MTARS; P.O. Box 932; Tullahoma, TN 37388-0932

Last name: ___________________________________________

First name: ___________________________________________

Call sign: _____________ License Class: Tech Tech+ Gen Adv Extra

Home telephone: (____)_____-_______ Cell: (____)_____-_______

E-mail address: _______________________________________

List on club web site? Yes( )No( )Your Pic: Yes( )No( )

Street address: ________________________________________

City: ______________________________State: ___ Zip:________

County of residence: ____________ DOB: ___________ mm/dd/yy or YR

Type of Membership Requesting? (please check)

Regular:_____ Family:______ Junior:______ Associate:_____

Are you a member of ARRL? Yes ( ) No ( ) Life ( )

Are you an A.R.E.S member? Yes ( ) No ( )