Last Name:    First Name:   MI:   
Call Sign:    License Class:    
Date of Birth:   
Address:    City:    State:   
Country:    Zip Code:   
Home Phone:    Work Phone:   
Email Address:   
Home Page Address:   
Other Club Affiliations:   
Comments:   
  
                               Membership Donation:    $30.00   

    I have read and agree with the SPIDER AMATEUR RADIO CLUB Constitution and By-Laws and with the provisions of the FCC Part 97 Rules and Regulations dealing with the Amateur Radio Service.   
    Additionally, I have been briefed by the Technical Committee or his/her representative about the club patch and operating procedure and fully understand it.   
                              

     
Applicant's Signature:    Date:    
  

    Please send a copy of your FCC issued Amateur Radio License together with the applicable donation to the SPIDER' s address below.  Your application will be processed after receipt of both requirements.  If you have a scanned copy of your picture and you want it to be posted on the club Members' List, please email it to the webmaster at [email protected].  A short write up of your background information will also be needed for the member's profile if so desired.  Thank you.