Membership Application   

Date:
Fists Number:
Call:
License Class:
Yr. 1st Licensed:
Name:
Address:
City:
Phone:
E-Mail:
Rig, Ant, etc:
Band Preference:
Other Notes:

As a part of this application, I hereby agree to operate my Amateur Radio Station in accordance with the applied FCC rules, and will also operate in Accordance with the Fists International CW Club and the Fists Club of North Carolina. Only North Carolina residents are considered "Full-Members" and are allowed to participate in club operating events. Use of club callsign, W4FFF, must be approved by the club station trustee.
Signed:

You may download and e-mail this application to w4fff@qsl.net. Just click on this link and save to your PC.

DownLoad Membership Application

--- OR ---

Mail this application to:

    Furman Doty W4MJT
    4625 Birgeheath Rd.
    Kernersville, N. C. 27284

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