CARBON AMATEUR RADIO CLUB
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CARBON AMATEUR RADIO CLUB |
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Application/Renewal of membership to the Carbon Amateur Radio Club (CARC)
| Name | __________________________________ Call Sign ______________ | |
| Address 1 | ___________________________________________________________ | |
| Address 2 | ___________________________________________________________ | |
| City | _______________________ State_______ Zip ____________________ | |
| Phone | (_______) ________ ________________ Unlisted Yes No | |
| ___________________________________________________________ | ||
| ARRL Member - Check One | Yes | Life | No |
License Class - Check One
| Novice | Technician | Tech Plus | General | Advanced | Extra | None |
In which club activities do you want to participate:
| Club Programs | Newsletter | |
| Education | ARES/RACES | |
| Field Day | Fox Hunting | |
| Other Activities -- Describe here | _____________________________________ |
| How would you like to receive the Newsletter? | Postal Mail | Web |
Membership -- Check One
| Full $15.00 | Associate $10.00 | Family -- each member is $5.00 additional |
Signature __________________________________________ Date _________________
Print this page, and send completed form above and check to:
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