The Georgia Radio Hall Of Fame

Membership Application

 THIS IS NOT A WEB FORM.

NAME:  MR. MRS. MS.

________________________________________________________________________

ADDRESS: _____________________________________________________________

CITY: __________________________STATE: ______________ ZIP: ______________

PHONE: _________________________ EMAIL: _______________________________ 

Your personal information will not be given or sold to any third party or published. 

I  AM CURRENTLY IN RADIO

 I  NO LONGER WORK IN RADIO 

I HAVE NEVER WORKED IN RADIO

I AM INTERESTED IN ATTENDING THE  INDUCTION BANQUET IN ATLANTA

LIFETIME MEMBERSHIP $25.00 

PLEASE MAIL COMPLETED FORM AND CHECK MADE PAYABLE TO "GEORGIA RADIO HALL OF FAME" TO:

GEORGIA RADIO HALL OF FAME

PO BOX 5313-ST MARYS, GEORGIA 31558

©  THE GEORGIA RADIO HALL OF FAME CORPORATION,2007

The Georgia Radio Hall of Fame is not affiliated with, but, fully supports the Georgia Association Of Broadcasters.

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