QCWA's - The Old Man
Upper Midwest Chapter 8 - Minnesota
Membership Application

Name ______________________________ Call _______ QCWA # __________*

Street Address ______________________________________________________

City ________________________________ ST ___ Zip Code ______-________

Birthday (MM/DD/YYYY) ___/___/______     Phone Number ____-____-______

Email id ____________________________________________________________

ARRL Member Life:___ Yes:__ No:__

* You must be a member of QCWA before you can be a member of Chapter 8.

Chapter 8 dues are $10.00 per year and payable by check or money order to
"QCWA-8" at any meeting or via USPS to:
QCWA Chapter 8
Tom Steele, AAØHQ
3570 Ridgewood Rd
Arden Hills, MN 55112