Membership Application

New or returning member?*

NewReturning

Name*

First NameLast Name

Parent/Guardian (if under 18)

First NameLast Name

Business/Organization (If applicable)

E-mail*

example@example.com

Phone Number*

Address*

Street Address

Street Address Line 2

CityState

Zip Code

What services do you plan on utilizing?*

Membership Fee*

Individual Full Access (Resident)

$30.00 for each year

Individual Full Access (Non-Resident)

$40.00 for each year

Individual Basic (Resident)Basic memberships are for members seeking airtime only. This does not include any equipment, training, or rentals.

$15.00 for each year

Individual Basic (Non-Resident)Basic memberships are for members seeking airtime only. This does not include any equipment, training, or rentals.

$25.00 for each year

Student/Senior (Resident)

$20.00 for each year

Student/Senior (Non-Resident)

$30.00 for each year

Business/Organization (Full-access)

$125.00 for each year

Business/Organization (Basic)Basic memberships are for members seeking airtime only. This does not include any equipment, training, or rentals.

$50.00 for each year

Total

$0.00

Email

Please verify that you are human*