Membership Application
Make checks payable to:  Bristol County Repeater Association, Inc.
Mailing address:  370 Perry St.,  Fall River,  MA 02721

 

___  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:

 

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