Membership App

HDARC Membership Application

Primary Member *

Y - Dues Paying Regular Member

V - First Year Free Membership

8 - 80 YRS OLD - FREE

Licensed Family Member *

Y

N

Auxiliary Member - Unlicensed

Y

N

Primary Member Renewal, New, Update Info, 80 YEARS *

Renewal

New

Update Personal Info

80 YEAR OLDS FREE

ARRL Member

Y

N

NEW HAM ONLY - First YR Free if tested by our VEC - Enter Tech test date MM/YY

First Name *

MI

Last Name *

Call Sign or PENDING *

E-Mail Address *

Home Address Line 1 *

Home Address 2/Mailing Address

City *

State *

Zip *

Home Phone *

Mobile Phone

License Class *

License Expiration Date

Date of Birth *

How Did You Find Us? (Web, Brochure, Word of Mouth, Other)

Other HAM Radio Organizations?

Date of Application or Update *

Pay by Check, PayPal, First Year Free, Update, or 80 YR? *

C

P

F

U - UPDATE

80 YR FREE

First Year Free only for those who took their Tech license from HDARC VE group

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