SCARC Membership Application  

Calendar Year 2000

    New / Renewal                 ARRL Member:   Yes/No
     (Circle  One)                                              (Circle  One)

[ ]  New Member ($25.00)	[ ]  Renewal ($25.00)	[ ] Senior, Over 60    ($15.00)
[ ]  Family Membership ($30.00)	[ ]  Current Members Update Only	[ ] Youth, Under 18   ($15.00)

CALL:_________________ CLASS: _________________EXPIRATION: ________________

NAME: FIRST __________________________INITIAL: ______LAST:_________________  

ADDRESS:___________________________________________________________________

CITY: ____________________________STATE: ______ZIP: ______________ - _________

Email Address:_______________________________________________________________

Deliver Newsletter via:  (Circle One)     Email        Hard Copy        

( ) OKAY, to publish telephone information     ( ) DO NOT publish telephone information

          Telephone Number: (_____)___________________

IF THIS IS A FAMILY (same household address) MEMBERSHIP, PLEASE COMPLETE THE FOLLOWING:

CALL: _______________________CLASS: _________________NAME: _______________

CALL: _______________________CLASS: _________________NAME: _______________

Mail to:  SCARC Treasurer,  P.O. Box 801524,  Santa Clarita, CA  91380-1524