A. NOTE: One fee for an Associate allows the same operating privileges for all licensed family members residing at the same address as the Associate. You must have a valid Amateur Radio License to become a CLARA Associate.

1. Your Name_____________________ Callsign_________ Nickname____________ Birthday__________

2. Family Ham_____________________Callsign_________Relationship___________Birthday__________

3. Other Family Hams in Household__________________________________________________________

B. Address______________________________City_________________________State_____Zip_________

Phone No.(required) Home________________Work_______________Occupation___________________

Shall CLARA keep address and phone no.confidential? Yes__ No__ (Officers and committees will have)

C. License Class_________ Date Expires_______ Prior Call_________ E-mail Address_________________

D. List other Ham Affiliations: A.R.R.L., R.A.C.E.S., Other Clubs___________________________________

E. List references with phone numbers (and call signs if they have one) 1._____________________________

2.________________________ 3.________________________4._________________________________

F. What is your purpose in wanting to join CLARA?_____________________________________________

G. By signing this application you agree to:

1. Allow your references and other data to be checked.
2. Supply additional information if, or when, requested.
3. Keep CLARA advised of your correct address, phone no. and change in Callsign.
4. Abide by decisions made by majority vote of the CLARA members.
5. Conform to and abide by the CLARA rules of courteous and considerate operating practices.
6. Operate within the part 97 F.C.C. Rules and Regulations.

I. Do you wish to be put on the waiting list for CLARA membership at this time? Yes______ No______

(PLEASE NOTE: You must be an Associate for a 6 month review period, during that time you must attend 2 out of the last 3 breakfast meetings or social events before being eligible for membership. An updated application may be required and an interview by the Membership Committee may be requested. Membership requires a vote of approval by the members. Member dues are $60 per year (dues may be paid $35/ 6 months). Members are also required to pay a one time initiation fee of $60. Members have access to the auto patches on 2 Meters, 440Mhz, 1.2 Ghz).

J. All supplied information is true and correct. ________________________________Date____________

(Signature)

For more information, print and mail your request to the CLARA Secretary, with a self-addressed stamped envelope to CLARA P. O. Box 7675 Huntington Beach, CA 92615

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