Membership Application Ten-Ten
International Net, Inc.
Once this form is
completed it will be sent to the Data Manager for processing, he will
in turn send you the link to the secure shopping cart to complete you
transaction.
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All Fields
Required unless otherwise noted
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| Name: |
Callsign: |
| Address:
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Year
of Birth (not required for Club stations): |
| City:
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State
or
Country: |
| Postal/Zip
Code: |
Email
Address: |
NOTE: 10-10, NUMBER, CALL, NAME, MEMBERSHIP STATUS AND
EMAIL ADDRESS IS MADE AVAILABLE TO ALL MEMBERS VIA A MEMBERSHIP ROSTER.
ALL OTHER INFORMATION IS KEPT CONFIDENTIAL AND NOT DISCLOSED EXCEPT BY
ORDER OF A LAWFUL COURT.
Can Correspondence with 10-10 International Net, Inc be done via your email address?
YES NO
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| I certify that I meet the membership requirements of 10-10
(typing your name on this form is the equivalent to your personal
signature): |
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