NANTICOKE AMATEUR RADIO CLUB, INC. - 2009 Membership application
New
Renewal
Call Sign
Full Name
Name used on the air
Address
City
State
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip + 9
Please include your area code
Evening Phone
Day Phone
Cell Phone
Email address
License class
Novice Technician Tech + General Advanced Extra Former Ham Not yet a Ham
ARRL Membership
Annual Life Not a member
Completed ARRL EMCOMM classes
None Level 1 Level 2 Level 3
Completed ICS700?
No Yes
Are you an ARRL accredited VE?
Select your membership category Membership period is the calendar year. Dues for 2009 are half price if joining between Aug 1 to November 30
Regular mbr
$ 20
Student mbr
Full time student under 23 years of age.
$ 10
Senior member
Are you age 65?
Family member
Regular member you live with
$ 5
Print and mail the form with a check/money order to NARC, P.O. BOX 135, SEAFORD, DE 19973
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