Full Name: Nick Name Home Address: Office & Address: Position: Home Tel.#: Office Tel.#: Cell Phone #: Email Address: Date of Birth (Day-Month-Year): Place of Birth: Marital Status: Name of Spouse: Highest Educational Attainment: Name of School: Religion: Alpha Phi Omega Chapter: Batch Name & Year: APO National ID #: Amateur Radio Call Sign: Make/Type of Radio Equipment: Class of Amateur Radio License: CLASS OF AMATEUR RADIO LICENSE CLASS A - Advanced Class CLASS B - General Class CLASS C - Technician Class CLASS D - Novice Class Unlicensed Class of Club Membership: CLASS OF CLUB MEMBERSHIP Regular Member - Licensed Honorary Member - Licensed Associate Member - Unlicensed CIRCLE Youth - 21 years old & below Status of Membership: STATUS OF CLUB MEMBERSHIP ACTIVE INACTIVE
Class of Amateur Radio License: CLASS OF AMATEUR RADIO LICENSE CLASS A - Advanced Class CLASS B - General Class CLASS C - Technician Class CLASS D - Novice Class Unlicensed
Class of Club Membership: CLASS OF CLUB MEMBERSHIP Regular Member - Licensed Honorary Member - Licensed Associate Member - Unlicensed CIRCLE Youth - 21 years old & below
Status of Membership: STATUS OF CLUB MEMBERSHIP ACTIVE INACTIVE