If you are interested in joining the Black Diamond Amateur Club please complete the form below. Club dues are $20.00 individual and 10.00 for each additional family member living in the same house that wants to be member as well. Make checks payable to BDARC and mail to:

NAME______________________________________________________

CALL SIGN:________________________________________________

ADDRESS:__________________________________________________

                               (Street/P.O. Box)

CITY:_____________________________________________________

STATE_____________________________________________________

ZIP CODE:_________________________________________________

PHONE NUMBER:_____________________________________________

E-MAIL ADDRESS:___________________________________________

LICENSE CLASS:____________________________________________

BIRTHDAY:_________________________________________________

                        (Optional)

ARRL MEMBER:______________________________________________

                        (Yes/No)