Arkansas Radio Emergency
Services Inc.
P. O. Box 22072, Little
Rock, AR 72221-2072
Membership Application
Date________________
Change of Address __ Renewal __ New Member Application __
Name
_________________________Callsign__________LicenseClass ___
Address_____________________________________________________________
City
_____________________________ State_______ Zip + 4 _____________
Telephone Number
____________(Unlisted?)_____ Birthday______
Email Address
____________________________________________________
ARRL Member? Yes____No____ Total
Enclosed _______
Sponsor’s Name and Callsign
___________________________________
Individual Membership $20
per year
Family
Membership per year: $20 for first member;
$10 for second member;
$5
for each member after that.
Applies
to immediate family only living in same household.
** Membership Renewals are
due in January of each year