Orange County Amateur Radio Club - W6ZE

2007 Membership Form

               Date:

    Last Name:    First Name:

    CALL LETTERS:

Class of License:       Extra            Advanced      General   

                                        Tech Plus   Technician    Novice

    Address (street):  

                          CITY:      State     ZIP

                      PHONE:     OK to Publish in ROSTER??  YES   NO

E-MAIL ADDRESS:  

DUES (Prorated Quarterly from January for NEW Members only)

      SINGLE MEMBERSHIP (Adult - $20 / yr).............$

     SINGLE MEMBERSHIP ( < 20 yrs old - $10/yr)..$

      First Additional Family MEMBER ($10 / yr).........$

                                           Member NAME         CALL:

   E-MAIL ADDRESS:  

      Second Additional Family MEMBER (Free / yr) $

                                           Member NAME         CALL:

ARRL Membership (normally $39 / yr,  $76 / 2yrs)...$

(NOTE:  pay for your ARRL membership thru OCARC...and OCARC will receive a commision)

OCARC BADGE ($3.00 each).........................................$

                     Name on Badge (Jim, Robert, Judy, etc.)

                     Name on additional member Badge         

       There is a $1 charge if you’d like badge mailed to you....$

                                      TOTAL Amount to Pay:    $

Please send check to :     OCARC

                                                PO Box 3454

                                                Tustin,   Ca   92781

Would you like to receive the CLUB NEWSLETTER via WEB / E-MAIL??     YES    NO

Are you currently an ARRL member??  YES    NO

 

Push the SUBMIT Button to automatically send this form to OCARC.

 

Back to OCARC Main Page

This page last updated on 10 February, 2007  by Ken W6HHC
OCARC S-Mail: P.O. Box 3454 Tustin, CA 92781
Copyright © 1997-2007 Orange County Amateur Radio Club