SABAH AMATEUR RADIO SOCIETY (Reg. No 1/78)
(Established since 1978. Member of Malaysian Amateur Radio Transmitter’s Society.)
ASIA ZONE : 28    ITU ZONE : 54

THE HON. SECRETARY,

APPLICATION FOR MEMBERSHIP
SABAH AMATEUR RADIO SOCIETY,


Colour 
Photo
2 pcs

 

Pass RA Exam
P. O. BOX 20940, 88766 LUYANG, 
   
KOTA KINABLU, SABAH, MALAYSIA.

Month/Year
I wish to submit herewith my application for membership as

Passed CW Exam
* Transmitting / Associate Member for consideration and approval.
   

Month/Year
Name:
Other Name: NRIC:

JTM Client ID. & Callsign
Date of birth: E-Mail:
   
Place of birth: Race: (if applicable)
Nationality:
Profession: Sex: * Male/Female

DESCRIPTION

AMOUNT
 [] Membership ID Card RM 10.00
 [] Entrance Fees RM 20.00
 [] Transmitting Member RM
(Sub. Fees RM 15/year) RM
 [] Associate Member RM
(Sub. Fee RM 5/year) RM

Total:

 RM

 
Company Name:
Address (Res.):
|
Address (Postal):
|
Tel (Res.): Tel (Off.):
Fax: H/Phone:

Charges for Membership ID Card, Fees for Entrance and Annual Subscription must be remitted together with the application form.
Enclosed Cash/Cheque/MO/PO no.: RM Add 50 sen Bank charges (outstation cheque)
UNDERTAKING TO BE SIGNED BY APPLICANT.
I, the undersigned, agree that in the event of my election to Membership of SARS, I will be governed by the Memorandum and Articles of Association of the Society and the rules and regulation thereof as they now are or as they may hereafter be altered. I further agree to observe strictly the terms of any licence issued to me by the relevant authorities to operate transmitting or receiving equipment.
Applicant’s 
Signature		  

Date

  

INTRODUCED AND SPONSORED BY:

Name:

Callsign:

Date:

Signature:
       

Date Received:

FOR OFFICIAL USE ONLY
 
 
 
 
 
 
MEMBERSHIP FOLIO

Date Approved / Not approved
 

Official Receipt No:
 

President

Hon. Secretary
Complete this form using block letters.

* Delete where applicable

 [] Tick where applicable
 

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