Join or Renew

Callsign*

Name*

First Last

Address*

Street Address City State ZIP Code

Phone*

Email*

ADXA Mailing List Subscription*

New members will be automatically subscribed to the ADXA e-mail reflector (mailing list). Our Quarterly Newsletter and meeting notices are distributed via the reflector. If you prefer NOT to be subscribed to the reflector please select NO below.

Yes, Please Subscribe
No, Do Not Subscribe

License Class*

Application Type*

New Member
Renewal

Sponsor*

Enter the Callsign of your ADXA Sponsor

ARRL Membership is required to join ADXA. ADXA is a 100% ARRL Affiliated Club.

ARRL Member?*

Yes - Standard Membership
Yes - Life Membership
No

ARRL Membership Expiration Month/Year*

Look on your QST Mailing Label for the Month/Year. Enter as MM/YYYY (Example: 12/2019)

DXCC Member*

Yes
No

Membership Type*

Individual Membership $25.00
Family Membership $35.00

Total

$0.00

Name

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Online Membership Application and Renewal Form