Border Amateur Radio Society

Registration Form

Name:

Call Sign:

Mailing Address:

City, State, ZIP code:

e-mail address(es):

Home phone number:

Work phone number:

Cell phone number:

License Class:

Check bands and modes that you can operate:

MODE	HF	6 meters	2 meters	222 MHz	440 MHz	Others
SSB
CW
FM
DATA
PACKET
Other modes (specify below)
Mobile Operation

Can your home station be operated without commercial power? Yes [ ] No [ ]

Signature_____________________________________ Date ______________

Mail completed document to Border Amateur Radio Society, PO Box 343, Del Rio, TX 78841