Print and send application and check (payable to: RRRA) to:

RIVER RAISIN REPEATER ASSOCIATION. INC.
567 West Vienna Rd., Temperance, MI  48182


Name ______________________________  Call ________________ ARRL Member? ___


Address ________________________________________  Phone _____________________


City  _____________________________________  State ______  ZIP _________________


E-Mail Address _____________________________________________________________


Speed Dial Slot #1 (@ $5.00)  ________  Desired Phone # ___________________________


Speed Dial Slot #2 (@ $5.00)  ________  Desired Phone # ___________________________


Membership: (@ $20.00) _________  Family Members (@ $5.00ea) ___________________


Total Enclosed:  ______________________________________________________________

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