Application for MTARS Membership

Membership year: ___________; Today’s Date:_____________

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

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

(2) $20 per year for Associate (non-voting or not licensed)

(3) Free for Junior (under age 17, non-voting members)

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:______________Class of license:________________

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

E-mail address:_______________________________________

Street address:________________________________________

City: ______________________________State: ___ Zip:________

County of residence:_____________DOB:___________mm/dd/yy

Type of Membership Requesting? (please check)

Regular:_____ Associate:_____ Junior:______

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

Rev: 2 01/31/2014