LARG Membership information
Please fill out this for when updating an existing membership or completing new membership to our club. Please note that we will not publish personal information on the Internet except for other club members to view. We will publish your name and call sign which is already public information.
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First Name *
Last Name *
Application type *
Email *
We will subscribe you to the mail lists using this e-mail address
Your FCC License Class *
What year were you first licensed?
Call Sign
Leave blank or use "None" if you do not have a call sign yet
Street Address *
City *
State *
Zip *
Phone number *
Type of Membership *
Are you a member of: *
Required
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