Old Post Amateur Radio Society Membership Application
Fill in all the information on the form and return it with the appropriate dues in person or mail it to the address above.
Name:Call:License:
Address:Status:3Phone #:
City:State:Zip:
Email:Date of Birth:Year Licensed:
Other Memberships
ARRLARESMARS RACESQCWA 10-X
Any other ham radio-related organizations, now or in the past?
 
Are you a Skywarn Member? If so, what is your assigned number.
 
INTEREST
Please list all Amateur radio interest you have: CW,Packet, etc.
 
 
 
Applying For Family Membership
Please list below the licensed family members living at home, that you wish to include
Name:
Call:
License Class:
ARRL/Other memberships
    
    
    
    
Payment1 Due:
Single Member ($15.00) 
Family Membership ($20.00) 
Student Membership ($10.00) 
ARRL Dues2 
Total Enclosed 
Notes:
1 - Payment made after October 31st applies to the membership for the following year.
2 - Your ARRL membership may also be paid through the club, enclose the appropriate forms with the amount due. ARRL also has a family membership program. See QST.
3 - Please indicate your membership Status in the space provided as: New,Renewal, Update (for mailings)
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