SVARA Membership Form



The online membership form is new.  If you experience difficulties, please let us know.

Call: License Class:
Name:     
Address:    
City: State:
Zip:    
       
E-Mail: Phone 1:
Web Site: Phone 2:
    Birthday:
Spouse Name: Anniversary:
       
Member: (licensed) Associate: (non-licensed)
Spouse: (of member or associate) Student:
Senior: Disabled Member:
       
    ARRL Member:   Yes     No
       
Comments
       

Total Dues: