LCARC

Logan County Amateur Radio Club

Membership Application

                      ____New      ____Renewal
 
Full Name:____________________________     Call Sign:_________________
Name used on the air:_________________     
Address:______________________________     Phone (    )___________
______________________________________     
___________________   Zip:____________                
 
E-Mail address:_________________________________________
 
 
                       License Class
                    
___ Novice             ___ Technician           
___ General            ___Extra
 
 
Membership Category 
----------------------------------------------------------------------
 
Membership is $24 a year and $6 a year for each additional member in 
your house. Or you may choose to pay on a monthly basis at $2 a month.                               
                                                   
                                                    $____________
 
                                
 
Signature________________________          Date_______________________
 
 
________________________________________________________________________

Welcome to the Logan County Amateur Radio Club!
 Your cancelled check is your receipt.
Make checks payable to the Logan County Amateur Radio Club

Send check or money order along with application to:

Logan County Amateur Radio Club
P.O. Box 792
Switzer, W.V. 25647