Carbon Amateur Radio Club
2006 Membership Application Form
Please complete this form
and send to the Carbon Amateur Radio Club, P. O. Box 622, Lehighton, PA
18235, or drop it off at the monthly CARC Meeting, at the Carbon County
EMA Center, Route 93. The meeting is on the third Thursday of each month at 7:30
PM.
Callsign
____________________ Name
___________________________
Address
__________________________________________________________
City
_________________________ State ____ Zip Code ___________________
Phone Number
_________________ Check if unlisted __
Email address
_________________________ URL _______________________________
Check if ARRL Member___
Membership (check one): Full ($15.00)____ Associate ($10.00)____
Additional family member
($5.00, up to a maximum of $25.00 per family)____
I would like to receive
the Newsletter via (check one): Postal Mail ____ Web ___
Check here if you would
like to be subscribed to the CARC Email Reflector _____
(Requires email address
above. Do not check if you are currently subscribed to the reflector)
What are your interests in
ham radio ? _______________________________________________
______________________________________________________________________________
What activities would you
like to see at CARC this year ? ________________________________
______________________________________________________________________________
I’m interested in (check
all that apply): Newsletter Writing ___ Tee
Shirts ___ Coats ____
Foxhunting ___ Special
Events Station ___ RACES ___ QRP ___ DX ___ Contests ___