Ellwood City Amateur Radio Association

Membership & Renewal Application

Please DO NOT send cash.  Check or Money Order only, please.  Make checks payable to ECARA. You may print the form and mail it along with your dues, or you can apply or renew online.  If you use the online option, your application will not take effect until we receive your dues.  Send applications and dues to:

E.C.A.R.A. Membership

  Dennis Neese 

413 Smiley Street, Ellwood City, PA  16117

ONLINE APPLICATION

Date:           Call Sign:    

Name:    License Class     

Address:  

City:     State:       Zip:    

County:         Email Address:  

Home Phone:      Cell Phone:    

Work Phone:       Other Phone:  

Birthdate:    Anniv:  

Spouse's name (If married) :  

Number of children:  

Names and ages of children:

Are you a member of the ARRL?   Yes   No

Are you a member of ARES?   Yes   No     SKYWARN?   Yes   No

Are you a VE?   Yes   No     If yes:   W5YI   ARRL

Do you have a handicap or any special needs?   Yes   No

If yes, please specify:  

What are your favorite modes of operation?  

Would you like to belong to, or are you a member of, any of the following committees?

     Public Relations Yes   No
     Social   Yes   No       
     Education & Training   Yes   No
     Fundraising   Yes   No        
     Construction   Yes    No
     Festival   Yes   No

Do you have any special talents or expertise?

   

Please read about our membership categories before applying

ECARA DUES BY MEMBERSHIP TYPE
Membership Type 1st Qtr

Full Year

 2nd Qtr

April-June

 3rd Qtr

July-Sept

 4th Qtr

Oct-Dec

Full $20.00 $15.00 $10.00 $  5.00
Family $  4.00 $  3.00 $  2.00 $  1.00
Associate $15.00 $11.25 $  7.50 $  3.75
Junior Free    N/A    N/A    N/A
Senior $10.00 $  7.50 $  5.00 $  2.50

Application Type: New   Renewal

Membership Type:  

Amount to be sent:

Dues (See Chart above)

Dues Amount    Amount Sent

Donation - Thank you!

Donation amount  

Comments:

         

     

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