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Mission Trail Net - the friendly Net - QRZ.com - ARRL.org - FCC.gov 3856 KHz |
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Dues $10.00 New member
Mission Trail Net Membership Application Click here to Print an Application for mailing
Renewal______ New_______ Date______________________________________
Call__________________ LicenseXClass_______________ ExpirationXDate__________ Handle____________________
Last Name_________________ First________________________ M.I_______ Date of Birth ___________(mo/day only)xxxxxxxxxx
MailXAddress__________________________________________City___________________________State_________
Zip_________________ County_______________________InternetXEmailXAddress_________________________
AreaXCode/HomeXPh.____________________AreaXCode/WorkXPh._____________________Extension____________
Occupation___________________________________________________________________________________________
PriorXCall(s)Xheld_____________________Hobbies/Interests_________________________________________
Spouse'sXName____________________Spouse'sXDOB_____________(mo/day only)XAnniversary Date_____________
Spouse'sXCall___________________SpouseXLic.XExpires__________________PriorXCall(s)Xheld_________________
Spouse'sXOccupation__________________________Hobbies/Interests____________________________________
Hobbies/Interests__________________________________________________________________________________
AreaXCoverage (forXtrafficXdelivery)__________________________________________________________________
Indicate if you wish to receive the Mission Trail Net newsletter (Blazer) every month by email, or every other month by United States Postal Services mail Check one: EMAIL______ (no fee) USPS______ (additional $10.00/yr)
Mail dues and application to Dan Farrell, Treasurer, 534 No. Whittier Street, Anaheim, CA 92806-3055
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