** PRINT THIS FORM **


CPARC
MEMBERSHIP APPLICATION
CUMBERLAND PLATEAU AMATEUR RADIO CLUB
www.CPARC.net
 
 
 


NAME: ______________________________________________________

AMATEUR CALL: ___________________ LICENSE CLASS: __________

STREET ADDRESS:_____________________________________________

CITY: _______________________STATE: ___ ZIP: ____________

TELEPHONE: _______________________ EMAIL: ___________________

CLUB ACTIVITIES INTEREST: FIELD DAY ___ REPEATER NETS ___ HF NETS ___ HAMFEST ___


Dues are $18.00/year. Send this application and a check for $18.00 to the Cumberland Plateau Amateur Radio Club, P.O. Box 2956, Crossville, TN 38557. WELCOME ABOARD!

 

 

 

 

 

form 04-14-2005