CSARA Membership Application

COLORADO SPRINGS AMATEUR RADIO ASSOCIATION
( C.S.A.R.A.)
P.O. Box 9194, Colorado Springs, CO 80932
2-Meters: 146.625- / 70 Centimeters: 448.725-

Name: ______________________________________ Call:_________________
Class: ___________________________ Expiration Date:__________________
Address:__________________________________________________________

         (Street/Box)            (City, State)          (Zip)

Home Phone: _____________________ Work Phone:____________________
Autodial Telephone Number?________________________________________
E-Mail Address: _________________________________________________
May your home phone be published in the group roster (Yes/No)? _____
Membership Type New [ ] Renewal [ ]

MEMBERSHIP FEES: The yearly membership fee covers all Amateur Radio Operators within a single family dwelling who are directly related to each other through marriage, birth or adoption.
Annual Fee: $20.00 per year for each autodial number.
Make checks payable to Colorado Springs Amateur Radio Association

Additional amateurs within the household:

Name: ________________________ Call: ___________ Class: ____________
Name: ________________________ Call: ___________ Class: ____________
Name: ________________________ Call: ___________ Class: ____________

All membership fees are good for a period of one year beginning March 1st. Please make your check in the amount of a $1.66 a month starting with the next calendar month through February. Payment of the annual membership fee entitles all amateur radio operators to membership in the CSARA. Membership voting is restricted to one vote per membership fee paid to the CSARA. Operational control of the repeater equipment is restricted to the CSARA Board of Directors or Charter Members of the organization. The Board of Directors or Charter Members may terminate operations at any time deemed necessary, without prior notice or refund of any fees paid to the association. Annual dues are non-refundable
I have read and understand this agreement.

SIGNATURE: __________________________________ DATE:________________