This is the first step of a two step process, this form is used to verify your membership information once this form is complete you will be directed to the shopping cart to complete the process.
As of November 29th 2010, Ten-Ten International Net has contracted PayPal™ to handle our secure transactions, this is the most recognized firm available for this service. When adding your purchases to the shopping cart you have two choices for payment. The primary being Credit Card, to accomplish this simply click on this logo that will be displayed on the check out page of the shopping cart:
All Fields Required unless otherwise noted
Please Note that Club Stations may not apply for life membership
Name: Callsign: Ten-Ten:
Year of Birth (not required for Club stations):
City: State or Country:
Postal/Zip Code: Email Address:
I certify that I meet the membership requirements of 10-10 (typing your name on this form is the equivalent to your personal signature):
Updated 12/10/2014 Copyright © Ten-Ten International Net, Inc. 2011
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