TASYL Membership Application Form
___ Full Membership (Licensed YL)
___ Associate Membership (___ Unlicensed YL or ___ OM)
Date _______________
Name _________________________________________ Call ______________
Address ____________________________________
City ______________________ State ________ Zip ____________
Phone _________________________
E-mail _________________________
Birthdate (day and month) _________________________
I am a member of ___ YLRL ___ ARRL.
My OM’s Call _____________ OM’s Name _____________________________
___ Please add an Associate Membership for my OM (add $5 per year)
Directions: Print this page. Fill in the appropriate blanks.
Send completed application with check for $5
($10 to add Associate Membership for OM--$5 for each) to TASYL secretary/treasurer:
Sylvia Hutchinson, K8SYL
9145 Bliss Rd
Lake Odessa, MI 48849
E-mail: k8syl@arrl.net