Membership Application Form

and First Class

First and Last Name *

Street Address *

City/Town *

State *

Zipcode *

Phone Number *

Email *

Callsign

License Class

FCC License Class

ARRL Member? *

Paying by Check? *

if YES, Please send your payment to the following address: West Chester Amateur Radio Association 8070 Tylersville Rd. West Chester, Ohio 45069

WCARA Agreement *

I Agree

I hereby submit this application to become a member of the West Chester Amateur Radio Association and understand and agree to abide by the Constitution and By-laws of the Association. The West Chester Amateur Radio Association is a division of the National Voice of America Museum of Broadcasting.