DeKalb County Amateur Radio Club Membership Application


Name:
Address:
City: State: Zip:
Amateur call sign: Home phone: Work phone:
E-mail address:
Website:

New / Renewal?:

If you only recently passed your ham test, some of these questions may not apply to you.

 
Are you an ARRL Member?:
Year you were first licensed:
Your current class of license:

Amateur radio interests:
Phone
CW

SSB

Satellite

Packet

FM

PSK31

Amateur Television

What type of equipment do you currently have?:

HF

VHF

UHF

Is your equipment emergency powered?:

Type of Application:  

Voting Member $12.00 per year

Associate (non-licensed) member $5.00

Family Member, in addition to voting member $5.00

Additional Members in same family: (Non-Voting, $5.00) (Voting, $12.00)

Name Call:
Name Call:
Name Call:
Name Call:

Please print and mail the form and make your check payable to: DCARC

Please mail to:

DCARC

16751 County Road 89

Mentone, AL  35984

 

 

Author, DCARC.
Copyright 2002 [DeKalb County Amateur Radio Club]. All rights reserved.
Revised: January 24, 2012

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