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Please Complete The Following Application For Membership.

Name *

First

Last

Address *

City *

State *

Zip Code *

Phone (xxx) xxx-xxxx

Current Amateur Radio License? *

Amateur Radio Call Sign(s) Related To This Application

*if applicable

SSRA Membership Level Applied For *

Choose member level and voluntary contribution

Email *

*for electronic delivery of SSRA roster and member communication. We never share email addresses

Request Anonymity?

if contributing only, not becoming a member, information will never be shared or made public

Comments?

How likely are you to recommend the SSRA to others?

Selected Value: 0

scale of 1/10

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