LCARC

Logan County Amateur Radio Club

Membership Application

  ____New ____Renewal
 
Full Name:____________________________ Call Sign:_________________
Name used on the air:_________________ 
Address:______________________________ Phone ( )___________
______________________________________ 
___________________ Zip:____________ 
 
E-Mail address:_________________________________________
 
 
  License Class
  
___ Novice ___ Technician 
___ General ___Extra
 
 
Membership Category 
----------------------------------------------------------------------
 
Membership is $24 a year and $6 a year for each additional member in 
your house. Or you may choose to pay on a monthly basis at $2 a month. 
 
 $____________
 
 
 
Signature________________________ Date_______________________
 
 
________________________________________________________________________

Welcome to the Logan County Amateur Radio Club!
Your cancelled check is your receipt.
Make checks payable to the Logan County Amateur Radio Club

Send check or money order along with application to:

Logan County Amateur Radio Club
P.O. Box 792
Switzer, W.V. 25647