Minnesota QRP Society Membership Form

Name/Call________________________________________________________

Address__________________________________________________________

City/State/Zip___________________________________________________

Phone__________________________Fax_______________________________

Email Address____________________________________________________

Packet Address___________________________________________________

Are you an ARRL member?__________________________________________

Club Affiliations________________________________________________

                      READ CAREFULLY PLEASE!
Number from 1 to 3  your three top interests, 1 being most
important:

      ___CW               ___SSB

      ___Ragchewing       ___Contests

      ___Scratch Building ___Kit Building

      ___QRPp             ___DX

      ___Club Activities  ___Other_____________________

Would you be willing to be involved in a club QRP 
Field Day Station?
                  ------
Willing to work the"FYBO Winter QRP Field Day"in 
late February?
              ------ 

Mail this form along with a $1.00 (Green Stamp)to:
Please do not send checks, put a dollar in the envelope.

Minnesota QRP Society
c/o Claton Cadmus KA0GKC
3985 Alabama Ave. So.
St. Louis Park, MN 55416