Moreno Valley Amateur Radio Association
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Tape measure Yagi
Moreno Valley Amateur Radio Association (MVARA)
and Emergency Radio Equipment Survey
Please enter your personal information then Submit this form.
( One person per form )
Regular Membership - $25.00 per year
New Membership - $12.50 If you join after July 1st
Member Personal Information
Indicates required field
New Member Application
Existing Member Renewal
Please tell us if you are new or renewing your existing membership.
Regular Member - $25.00
$12.50 - New member joining after July 1st
Please select your membership type
Date of Birth
Enter your call sign here
Class of License
Note to club:
Any thing you wish to tell us about you or your information
Home Phone Number
Enter your Home Number ** If you only have 1 phone, enter the same number for both Home and Cell to complete the form.
Cell Phone Number
Enter Cell phone ** If you only have 1 phone, enter the same number for both Home and Cell to complete the form.
Changes in Personal Information since last year?
Have you changed your address or other info since last year that we need to know about?
Additional Information about you and your Station
Are you a member of any of these Groups?
Check all that apply
RACES: what is your unit?
Tell us your Unit
MARS: what is your Branch
Tell us your Service Branch
ACS: what is your Unit?
Tell us you Unit
Which of the following do you have the equipment to preform?
HF - 10 M only
Please check all that apply
Explain other equipment
Please let us know how to expect your dues payment.
Please select one on these payment methods
I will bring my payment to the next MVARA meeting
I will call or e-mail the Treasurer and make payment arangements
I will mail the payment to the address shown below
Please tell us how you will pay your membership dues.
Thank you for your application. Please double check your responses, then CLICK the SUBMIT button.
Completed form may be submitted and dues paid to the Treasurer at the monthly
membership meeting, or form and check mailed
to: MVARA, c/o 8365 Maynard Lane,
Riverside, CA 92508. [rev 1/19]
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