Green Mountain Repeater Association
Membership Renewal Form
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Instructions: Enter the fields below and then click the "Submit" button at the bottom of the screen.  This will send your renewal form 
but not the required membership fee.  Return to the GMRA web page to click the PayPal.me/gmraMD link to make payment.

  
 
    
Call Sign
License Class
 
Green Mountain Repeater Association
MEMBERSHIP RENEWAL FORM
First Name
Middle Name
Last Name
Suffix
Address
City
State
Zip Code
Home Phone
Work Phone
Cell Phone
Email Address (Required)
Occupation (for statistics only): Are you an ARRL Member?
 
Family Members: (You can add up to 3 additional hams living in the same household at no additional charge)
First Name
Last Name
Call Sign
Lic Class
Email Address
First Name
Last Name
Call Sign
Lic Class
Email Address
First Name
Last Name
Call Sign
Lic Class
Email Address
Notes: (Anything you want to tell us about this application?)
The Annual Membership Fee is still Only $15.00!   Some members also like to make a donation (not required) to our equipment fund.   Typical donations are in the amounts of $5, $10, $15, $20, $25, $30, $35, $50, or any other amount. Please enter the amounts below that you will be sending via the PayPal app.
Membership Fee Amount ($15.00): Donation (if any): Total to be Submitted: $
      (Use PayPal button on the GMRA website or at the end of this submission to submit your payment)
By submitting this application you agree to abide the the Green Mountain Repeater Association's Rules & Bylaws, available on the GMRA website.
             
Call Sign
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License Class
{LIC_CLASS}
Green Mountain Repeater Association
{_UNBOUND_STATICTEXT_1}
First Name
{FIRSTNAME}
Middle Name
{MIDDLENAME}
Last Name
{LASTNAME}
Suffix
{NAME_SUFFIX}
Address
{ADDRESS}
City
{CITY}
State
{STE}
Zip Code
{ZIP}
Home Phone
{HMPHONE}
Work Phone
{WKPHONE}
Cell Phone
{CELLPHONE}
Email Address (Required)
{EMAIL}
Occupation (for statistics only): {OCCUPATION} Are you an ARRL Member? {ARRL_MEMBER}
Family Members: (You can add up to 3 additional hams living in the same household at no additional charge)
First Name
{FAMILYFIRSTNAME_1}
Last Name
{FAMILYLASTNAME_1}
Call Sign
{FAMILYCALLSIGN_1}
Lic Class
{FAMILYLICCLASS_1}
Email Address
{FAMILYEMAIL_1}
First Name
{FAMILYFIRSTNAME_2}
Last Name
{FAMILYLASTNAME_2}
Call Sign
{FAMILYCALLSIGN_2}
Lic Class
{FAMILYLICCLASS_2}
Email Address
{FAMILYEMAIL_2}
First Name
{FAMILYFIRSTNAME_3}
Last Name
{FAMILYLASTNAME_3}
Call Sign
{FAMILYCALLSIGN_3}
Lic Class
{FAMILYLICCLASS_3}
Email Address
{FAMILYEMAIL_3}
Notes: (Anything you want to tell us about this application?)
{TEMPNOTES}
{_UNBOUND_STATICTEXT_4}
Membership Fee Amount ($15.00): {MEMBERSHIP_FEE} Donation (if any): {DONATION} Total to be Submitted: $ {TOTAL_FOR_GRID_ONLY}
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{_UNBOUND_STATICTEXT_2}
 
 

  
 
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