**********************Margarita and Martini 10-10 Chapter Online Application TEXT File*************************



Greetings from the Margarita and Martini 10-10 Chapter of Georgia. Please fill out all information below and please
send back to K4JPC@inbox.com. This is an online application form to become a member of the chapter. Please fill in the
following information below and when it is sent back in you will be issued a M&M number in sequence of the filing. Please
make sure you include all information below. Any infomation that is not filled in may be subject to a chapter approval 
beyond the Chapter Head's control. The sooner you respond to this form the sooner you will be issued a number. There is no
cost to join the chapter and we welcome all licenced radio amatuers. As of April 28th 2009 you now need to be a member of 
10-10 International to join the Margarita & Martini 10-10 Chapter of Georgia.



Margarita and Martini 10-10 Chapter Online Application


NAME:

STATE OR COUNTRY:

10-10 NUMBER:

10-10 EXP DATE:

Question:

The person that is applying, why do you wish to become part of the chapter? Also what primary mode on 10 meters do you 
operate such as SSB / RTTY / PSK31? Your answer will only be viewed by the chapter head only used for reference. 



Please respond to the question above below:












Thanks again for your application. It will be reviewed for approval on return of email.




Bobby K4JPC / Chapter Head
Rick WD4ABO / Ceritifcate Mgmr.
Margarita & Martini 10-10 Chapter of Georgia