Milton Amateur Radio Club
P. O. Box 4072
Milton, Florida 32572-4072

Membership Application

Date:____________________


Name:______________________ Call Sign:____________ Classification:_________

Address:________________________________________________________________

Phone:____________________________ E-mail Address:_______________________

Date of Birth:_______________ Are you an ARRL Member: ( Yes____ ) ( No____ )

Spouse’s Name:_____________________________ Date of Birth:________________

Associate Membership for Spouse: ( Yes____ ) ( No____ ) At No extra cost.

Annual Dues are $15.00 per year.
Dues are payable the first meeting in January.
New members enrolling during the year will have their dues prorated according to the remaining months of the year.