SMARC Membership Application
Name (First and Last) *
Your answer
Mailing Address *
Your answer
City, State, Zip *
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Phone Number
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Email
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Subscribe to email List? *
Callsign
Your answer
License Class
What year were you licensed?
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What is your birth date? (optional)
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Do you agree to provide payment at the next meeting or mail a check for $25.00(Full Membership) or $12.50(Youth Membership) or $37.00(Family Membership), membership pro-rated quarterly from January to December? (Mailing address furnished upon request) *
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