Name: _____________________________ Call Sign:________
Address:_____________________________ Phone: _________
City/State/Zip: _______________________________________
Club Membership Types (please circle your choice)
Regular $17. Family $8. Per each additional member
Associate $11.
(An Associate membership is for Repeater support.
It is not an active, voting membership choice)
Names/Calls of Additional Family Members: __________________
____________________________________________________
ARRL Membership: (Joining the ARRL through the ARCC
enables the club to retain $15. For each 1st. time 2 year membership.)
(Please circle your choice)
Regular 1 year $39. Reg. 2 years $76. Reg. 3 years $111.
Senior 1 year $36. Senior 2 years $70. Senior 3 years $103.
Are you currently an ARRL member? Yes / No
Please make your check payable to ARCC and mail to:
Amateur Radio Caravan Club
P.O. Box 36365
Albuquerque, NM 87176-6365
__________________________________________________
Special Service Interests:
Are you interested in any of the following committees or events?
Repeater Maintenance/Improvement? Yes / No
Field Day? Yes / No
Winterfest? Yes / No
Nominating Committee? Yes / No
Audit Committee? Yes / No
Special Events? Yes / No
Being A Club Officer? Yes / No
Any Other Special Interests? __________________________