Roane County Amateur Radio Club Membership

January 01, 2004 to December 31, 2004

Call _______________

License Class: circle one N T P G A E

Name: first ___________________ mi. _____ last ________________________ nick name ____________________

Date of Birth ___ ___-___ ___

month day

Address _________________________ City ________________________ State ______ Zip ________

Telephone # ______ - _________ Email address ________________@____________________________

Rpt. Mail Box # _______ Mail Box Telephone # ______ - ___________

Member: ARRL circle one Yes No

Remarks:

Dues Paid

Club Dues: $15.00 Amount enclosed: $ __________

Associate Member: $ 7.50 Amount enclosed: $ __________

Repeater Contribution: Amount enclosed: $ __________

Total amt. Enclosed: $ __________

Signature: ___________________________________ Date: ____________

Please complete and return to: R.C.A.R.C.

P.O. Box 1104

Kingston, TN. 37763-1104

Monday night net at 9 pm ET on 147.015 MHz repeater.

Monthly club meeting on the second Thursday, at 7 pm eastern time. Location: The conference room at the Roane State Agricultural Exposition Center. Always come early and leave late to enjoy an eyeball QSO.

New memberships are welcome anytime.