ADDRESS: __________________________________________________________

CITY/TOWN: ________________________________________________________

PROV.: __________ POSTAL CODE: _________________

RES. PHONE #: ________________ BUS. PHONE #: ______________

MALE _______ or FEMALE ______, DATE OF BIRTH _______________

ORDINARY MEMBERSHIP: ___, ASSOCIATE MEMBERSHIP: _____

CALL-SIGN: ________________

FEES:

ORDINARY - $10.00, ASSOCIATE - $1.00

ORDINARY : ____ X $10.00 = ____________

ASSOCIATE : ____ X $1.00 = ____________

DONATIONS : =                            ____________
                                                          ____________

TOTAL AMOUNT SUBMITTED = ___________

DUES ARE RENEWED AT THE SEPTEMBER GENERAL MEETING.

ARE YOU PRESENTLY A MEMBER OF ANY OTHER CLUB?

STATE CLUBS :_______________________________________________________

IF YOU AGREE TO ABIDE BY THE CLUB'S BYLAWS ATTACHED WITH THIS APPLICATION, BY GIVING THE SIGNATURE OF CONSENT REQUIRED, AND SPONSORED BY A CLUB MEMBER IN GOOD STANDING. THE APPLICATION WILL BE RECOMMENDED BY THE BOARD OF DIRECTORS, AS STATED IN S.E.A.A.R.C. BYLAWS, (ARTICLE 2, ITEM e.), TO THE MEMBERSHIP AT THE REGULAR MEETING FOR FINAL ACCEPTANCE.
 
 APPLICANT'S SIGNATURE ___________________________________________________________

APPLICANT'S CALLSIGN ________________________________

SPONSOR'S SIGNATURE ____________________________________________________________

SPONSOR'S CALLSIGN _________________________________ 

DATE OF APPROVAL _________________________________