On-line Application

Please enter your personal information then Submit this form. ( One person per form )

Regular Membership - $25.00 per year

Member Personal Information

Please Select *

New Member Application Existing Member Renewal

Call sign *

Class of License *

Email *

Note to club: *

Home Phone Number *

Cell Phone Number *

Changes in Personal Information since last year? *

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Address *

Line 1

Line 2

City

State

Zip Code

Country

Additional Information about you and your Station

Please let us know how to expect your dues payment.

Please select one on these payment methods *

I will pay now using the Pay Now button below I will mail the payment to the address shown below

Thank you for your application. Please double check your responses, then CLICK the SUBMIT button.

Moreno Valley Amateur Radio Association (MVARA)Membership Application and Emergency Radio Equipment Survey