MARC -- Membership Application Form

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New Membership Application

Membership covers all member priviledges including quarterly issues of the Michigan Antique Radio Chronicle. All memberships expire the last day of each calendar year.

Membership Dues
	Entire Year:	$20.00
	Last Half of Year:	$10.00

Fill in the form and send it along with a check for the appropriate amount. Once your application is received and processed, you will be sent your membership card.

Mail the printed form and dues to:

Michigan Antique Radio Club
22400 Nowlin
Dearborn Mich 48124

Make checks payable to " MARC ".

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New Membership Application

Name
Last:		First:		Initial:

Address
Address 1:
Address 2:
City:	State:	Zip:
Country:

Contact
Phone Number:	( ) -
Email:

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