Last Name: First Name: MI: Call Sign: License Class: Date of Birth: Address: City: State: Country: Zip Code: Home Phone: Work Phone: Email Address: Home Page Address: Other Club Affiliations: Comments: Membership Donation: $30.00
I have read and agree with the SPIDER AMATEUR RADIO CLUB Constitution and By-Laws and with the provisions of the FCC Part 97 Rules and Regulations dealing with the Amateur Radio Service. Additionally, I have been briefed by the Technical Committee or his/her representative about the club patch and operating procedure and fully understand it.
Applicant's Signature: Date:
Please send a copy of your FCC issued Amateur Radio License together with the applicable donation to the SPIDER' s address below. Your application will be processed after receipt of both requirements. If you have a scanned copy of your picture and you want it to be posted on the club Members' List, please email it to the webmaster at [email protected]. A short write up of your background information will also be needed for the member's profile if so desired. Thank you.