Membership form online

Name

First

Last

Callsign

what is your ham radio callsign?

Your current License Class

Email

What is the email address that you would like to use for EPARS club notifications?

Your mailing address

Where do you live? Street or P O Box is ok.

City

State

Postal Zip Code

Phone number – Home

If you have a landline phone please let us know.

Phone number – Cell

What is your cell phone number?

What is your cell phone carrier?

Verizion , AT&T , MetroPCS, ???

Are you a year round resident??

If no please provide your temporary Florida address ( Street ,city, State, Zip )

List your Street ,city, State, Zip

For family membership, list other persons and Callsign

Are you an A.R.R.L. member??

Other radio related memberships you are in

Current operating mode(s)

Let us know what mode or band you like to operate on.

I am interested in