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Buckeye Belles Application for Membership

Renewal _______ New Member _________ Year:20_____

Name________________________________ Call______________ Belle # ______ (if applicable)


City________________________________ State______ Zip_________

Phone______________ Unlisted (Y/N)___ Birthday______ (month/day only)

Email address: ________________________       web page: _____________________________

packet address:________________________

License class ____________       Occupation_____________________________

Married Y__ N___       Is Ohio YL, is OM a Beau? Y__ N__

If Y, OM's name/call _____________      OM's DOB ______

YLRL Member Y__ N__       ARRL Member Y__ N__

Other amateur radio clubs you belong to: ____________________________________________

Other Hams in Family____________________________________________

Other Activities and Hobbies____________________________________

In what way would you be interested in helping the Buckeye Belles
(please circle all areas you are interested in):

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Dues are due by March 31st for the Belles. Use the application form above to mail in your dues with the appropriate amount to:

Jean Ruth, KB8YHN
192 N Pleasant St
Oberlin, OH 44074-1123

Dues for the Buckeye Belles

Ohio Belles Regular Member $10
Out of State YLs Associate Member $8
Members residing at same address Family Member $1
DX YLs DX Member $11
OM of OHIO YL member only! Buckeye Beau onetime fee of$1
Subscriber Subscriber Member $8

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