CALHOUN,
GEORGIA
NAME:
____________________________________CALL: ______________CLASS: _________________
YEAR
FIRST LICENCED: ___________ YOUR BIRTHDATE: MONTH________ DAY___________
ADDRESS:
___________________________________________________________________________
CITY,
STATE, ZIP CODE:________________________________________________________________
PHONE
NUMBER:HOME_______________________ WORK__________________________________
E-MAIL
ADDRESS: _________________________ BEEPER: ________________________________
CELL
PHONE: ___________________ WE
WOULD LIKE YOUR HOME NUMBER. ALL
OTHERS ARE OPTIONAL.
ARRL
MEMBER: _____ ARES
MEMBER: ______ WOULD YOU
LIKE TO BECOME A MEMBER___________
ARRL
APPOINTMENTS HELD:
____________________________________________________________________
OTHER
AMATEUR RADIO ORGANIZATIONS AFFILIATIONS:
________________________________________
MODES
OF OPERATION: VHF/UHF____ HF___ CW___ PACKET____ OTHER__________________________
FAVORITE
BANDS OF OPERATION_____________________________________________________
MOBILE:
_______________ EMERGENCY POWER: __________________________________
TYPE
OF MEMBERSHIP: CHECK ONE: FULL: _______ FAMILY: __________ ASSOCIATE: _______
IF
A FAMILY MEMBERSHIP COMPLETE THE FOLLOWING:
FAMILY
MEMBERS:
NAME:__________________________________
CALL:__________________ CLASS:______________
NAME:__________________________________
CALL:__________________ CLASS:______________
NAME:__________________________________
CALL:__________________ CLASS:______________
TYPES
OF MEMBERSHIPS
FULL
MEMBERSHIP:
DUES ARE $12/YEAR. FULL MEMBERSHIP
AFFORDS LICENSED AMATEURS FULL BENEFITS AND PRIVILEGES.
NEW MEMBERS ARE PRORATED AT $1 PER REMAINING MONTHS.
FAMILY
MEMBERSHIP:
DUES ARE $5/YEAR. FAMILY MEMBERSHIP
SHALL BE AVAILABE TO ANYONE LIVING IN THE SAME HOUSEHOLD OF A FULL
MEMBER. IF THE FAMILY MEMBER IS A
LICENSED AMATEUR THEY SHALL HAVE FULL BENEFITS AND PRIVILEGES.
IF NOT LICENSED THEY MAY NOT VOTE OR HOLD A CLUB OFFICE.
NEW MEMBERS ARE PRORATED AT $0.50 PER MONTHS
ASSOCIATE
MEMBERSHIP: DUES ARE $8/ YEAR. ASSOCIATE
MEMBERSHIP IS AVAILABE TO NON-LICENSED PESONS.
ASSOCIATE MEMBERS SHALL NOT BE ELIGLIBE TO HOLD AN ELECTED OFFICER’S
POSITION AND SHALL NOT HAVE VOTING PRIVILEGES.
NEW MEMBERSHIPS ARE PRORARTED AT $0.70 PER REMAINING MONTHS.
FOR
CLUB SECRETARY USE ONLY:
DATE
OF APPLICATION: _________________ FIRST READING_________________
SECOND
READING_______________ APPROVED Y/N____________________