MEMBERSHIP APPLICATION
SIERRA AMATEUR RADIO CLUB of the HIGH MOJAVE
Please fill out this form. It is used to make the club roster and newsletter mailing list. 
This form must accompany all membership, badge and patch payments. All renewals are due 1 January. 
Memberships not renewed by 31 March are dropped from the membership roll. 
Please mail this application and your payment to
SARC, POB 1442, Ridgecrest, CA 93556-1442 or give them
to the Treasurer at a meeting.

	Type of membership	New or Renewal	July - December
	Individual	$20.00	$3.00 + $1.50/mo.
	Individual (Newsletter via Email only)	$17.00	$3.00 + $1.50/mo.
	Full time student or active duty military	$10.00	$1.50 + $0.75/mo.
	Family (One Newsletter) 	$30.00	$4.50 + $2.25/mo.
	Family (One Newsletter, via Email only) 	$27.00	$4.50 + $2.25/mo.

Individual or First Family Member	Date ______________________

Name: Last__________________________ First______________________ MI_____   Call Sign_______________
Newsletter Format    Printed via mail ____     Email PDF ____    Email Plain Text _____
E-Mail Address______________________________________ (Email address is not shared, for newsletter only)
Note: The following only needs to be filled out IF info has changed,
new member or more than a year since last renewal
Mailing address: ________________________ City__________________________
State________________________ Zip______________________
Phone: Home______________ Work________________ License Expire Date_________
Novice___ Tech___ Tech Plus___ Gen___ Adv___ Ex___     ARRL Member : Yes _____    No ______

Second Family Member (For more family members please duplicate)

Name: Last__________________________ First______________________ MI_____
Note: The following only needs to be filled out IF info has changed,
new member or more than a year since last renewal
Phone: Home______________ Work________________ License Expire Date_________
Novice___ Tech___ Tech Plus___ Gen___ Adv___ Ex___    ARRL Member : Yes _____    No ______

	TOTAL $_______________

_________________________________________________________________________________________________
DO NOT DETACH	BADGE  ORDER	DO NOT DETACH
The club badge shows your Amateur Call, your Name and Sierra Amateur Radio Club.
It will identify you at club meetings and public service events.
To order a badge, provide the information below and, include $7.00, for each badge
in Membership Application total above or with this form and mail to
SARC, POB 1442, Ridgecrest, CA 93556-1442 or give it to the Treasurer at a meeting.
First Badge
Name to put on my badge is_____________________  (What you like to be called)
Amateur call for my badge is____________________
Second Badge
Name to put on my badge is_____________________  (What you like to be called)
Amateur call for my badge is____________________