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