3900 Club application form
Lifetime membership in the 3900 Club is $5.00 and NO annual dues. The 3900 Club is an affiliated ARRL Club and is Incorporated as a non profit organization in the state of Iowa.

First Name:

Last Name:

Callsign:

Street address:

City:

State:

ZIP:

Email:

Birthday:

Phone:

License Class:

Expiration date:

ARRL:

XYL's Name:

XYL's Call:

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