ALGER AMATEUR RADIO CLUB
308 West Chocolay Street
Munising, Michigan 49862
Application for Club Membership
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NAME:__________________________________________________ CALL:_____________ LICENSE CLASS:(circle) N T T+ G A E ADDRESS:_______________________________________________ CITY:___________________________STATE:_____ZIP:___________ E-MAIL: _________________________ BIRTHDATE:____/_____/____ HOME PHONE: (_____)__________WORK PHONE:(_____)___________ I belong to (circle): ARRL RACES ARES MARS NTS Other clubs:________ Bands used (circle):160m 75/80m 40m 30m 20m 17m 15m 10m 6m 2m 70cm Modes used (circle): SSB FM CW Packet RTTY SSTV ATV Amtor/Pactor Mobile equipment:____________________________________________ Fixed station:________________________________________________ Check the appropriate category/categories: _____FULL MEMBER $25 (Licensed Alger County Resident) _____SUPPORTER MEMBER $20 (Licensed Non-Resident) _____JUNIOR SUPPORTER MEMBER $10 (Opened to anyone) _____FAMILY MEMBER $10.00 (must be licensed and reside at same address) ______________________________ Name, Call, License, etc. |
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