LWRA Online Membership Application

MEMBERSHIP APPLICATION

Callsign *

Class *

Name *

Address *

Apartment Number, Lot Number, or Other Address Info

City *

State *

Zipcode *

Phone Number *

Email Address *

Method of Paying Dues

ARRL Member *

Yes

Consent to Apply for LWRA Membership *

I herewith apply for membership in LWRA, Inc. and submit full payment for dues for the current membership term. By placing my signature below, I agree to abide by all by-laws and governing documents of the organization that are in effect during the term of my membership.

Signature *

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METHOD OF PAYING DUES

(1) You may scan the QR Code below to pay dues via PayPal:

(2) Dues may be paid by mail. Please make checks or Money Orders payable to:

LWRA, Inc.
P.O. Box 54
Lake Wales, FL 33859

(3) Dues may be paid in person at any regular LWRA meeting to the club treasurer.

For more information on the dues schedule, please go to the LWRA Dues Information page.

Lake Wales Radio Amateurs - K4LKW

LWRA Inc. - An Amateur Radio Club and a 501c3 non-profit - also known as the Lake Wales Repeater Association

MEMBERSHIP APPLICATION

METHOD OF PAYING DUES