E.A.R.S. Membership Form 2012

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      Name      
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      License Class:

Annual Membership Dues:
$10.00 Single, $15.00 Family, $5.00 Senior(over 65)
After January 15
$15.00 Single, $20.00 Family, $10.00 Senior(over 65)
     Type of membership:

List Family members below:(Family Membership)

Make checks payable to E.A.R.S. and mail to:
                     Ephrata Area Repeater Society, Inc
                     PO Box 674
                     Ephrata, PA 17522


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