Date:________________________
TO: The Penn-Mar Radio Club, Inc.
P.O. Box 763
Hanover, PA 17331
Having an interest in Amateur Radio, I hereby apply for membership in The Penn-Mar Radio Club as follows (Please type or print information):
Applicant's name (First)__________________(MI)_____(Last)_____________________
Call Sign (if any):__________ (Class of current license, if any)______________
Street address:_______________________________________________________________
P.O. address (City, town):____________________ (State):_____ (Zip):___________
Home phone: (_____) _____ - ___________ Bus. phone: (____) _____ - ___________
Your current age (only if applying for senior membership):_______________.
Name of full member of whose family you are a member (only if applying for family membership:_____________________________________________
Are you an ARRL member? ________. (Note ARRL membership is not required for membership in the Club, but, as an ARRL Special Service Club we are asked the percentage of our membership who are also ARRL members. We do strongly encourage amateurs to join the ARRL.
Date your membership is to commence:____________________________.
Amount of dues tendered herewith (see proration schedule). $_________________
The Club's standing committees are: Repeater, Specialized (Digital) Modes, Station, Interference, YARS, VE, Education, Hamfest (joint with York Hamfest Foundation), Activities, and Public Relations. Please indicate the committees on which you would be interested in serving (if any):
_________________________________________________________________.
Signature:___________________________________
FORWARD APPLICATION TO CLUB AT ADDRESS ABOVE.