Membership Application Make checks payable to:  Bristol County Repeater Association, Inc. Mailing address:  45 Beth Road.,  Tiverton,  RI 02878-3701

 

___  Application for individual membership  Dues $20.00 per year

___  Application for family membership  Dues $25.00 per year

___  Application for Student membership (under 18) Dues $10.00 per year

___  Renewal of membership  Dues as above

 

                                    PLEASE  PRINT  CLEARLY

 

Callsign __________     License expiration __________     Class _________

 

Name ________________________________________________________

 

Address ______________________________________________________

 

City _________________________   State  _____  Zip _________________

 

E-mail address _________________________________________________

 

Home telephone number (Please include) ____________________________

If you do not want your telephone number listed it will be restricted to association officers.

Do you want your telephone number published on the monthly club roster?   Yes_____  No _____

 

Do you want a repeater speed dial allocated for your use?  Yes _____  No _____

Speed dial allows you to quickly dial the one phone number you call the most over the repeater.

 

Are you currently an ARRL member?   Yes _____ No _____

Would you like information about the ARRL?   Yes _____ No _____

Would you like an ARRL application?     Yes _____ No _____     Joining the ARRL through this club
benefits the club and costs no more than if you joined separately.  ARRL dues currently $39.00 per year.

 

Areas of interest:                 _____ Club May Dxpedition (Martha’s Vineyard)

                                                _____ Club ‘Geekfest’     _____ Field Day

                                                _____ Emergency communications and participation

 

Please include any other information or questions:

 

______________________________________________________________________

 

______________________________________________________________________

 

______________________________________________________________________

Test Application Form

Application for individual membership  Dues $20.00 per year
Application for family membership  Dues $25.00 per year
Application for Student membership (under 18) Dues $10.00 per yea
Renewal of membership  Dues as above

Call Sign

License Expiration Date

No License Yet Novice Technician General Advanced Extra License Class

  First Name

  Last Name

Street Address

City/Town        State        Zip Code


  Telephone Number

  E-Mail

Yes No   Are you a current ARRL Member?

Ham Radio Areas of Interest (Check all that apply)
Morse Code
SSB
  AM
  HF Operating
  VHF/UHF Weak Signal
Repeaters
Digital Modes / Data Transmission
  Satellites & ISS
  Antennas
  Circuit Building & Design
  Software Design
  Amateur Television
  Emergency Communications
  Public Service
  Weather Spotting
  Mobile Operating
  Radio Contesting
  Portable Operation


Please tell us a little about yourself, or any areas of interest you may have.


Please hit the SUBMIT button and somebody from the BCRA will contact you soon!