Clinton County Amateur Radio Association Membership Application www.ccara.net
Please print this page and mail application to: CCARA Treasurer PO Box 222 Martinville, OH 45146-0222
The Clinton County Amateur Radio Assn. (CCARA) welcomes you to join our club. The dues are only $10 per year and $5 per additional family member.
Please complete the application below then give it to a club member, bring it to a meeting or mail it to the address listed above.
Name: __________________________ Call Sign: _____________
Address: _______________________________________ ______________________________________________
City: ________________________________ State:_____________ Zip: ____________
Phone Number: (____)___________ Email Address (Optional): ______________________
Birth Date (Optional): ___________ License Class: _________ ARRL Member? Yes No
Annual Membership Fee: $10
Number of additional family members joining (if applicable): _____ x $5 = $_____
Total Enclosed: $_________
Please make checks payable to: CCARA