ASSOCIATE MEMBERSHIP APPLICATION
- NAME: __________________________________________________ Member
of The ARRL?
Y N
$20.00 Full Member
-
- ADDRESS: _________________________________
$10.00 Associate
Member
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- CITY: __________________
STATE: _________________ ZIP: ____________
$5.00
Family Member
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- PHONE: ( ___ ) -_______________
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- Call Sign (If none, write
'NONE'):___________________(Class)_______________
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- Name of any Family
Members: _____________________________Callsigns of any Family Members:____________(Class)__________
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- Referred to club by? (i.e.: net, friend, webpage.... etc):
________________________
Brief description of radio gear you own and your primary interests in Ham Radio.
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- _______________________________________________________________________________________________________
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- _______________________________________________________________________________________________________
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- *How many years have you been licensed?
_________________________________
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- *Previous callsigns held?
_____________________________________________
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- Would you be willing to 'ELMER' a fellow ham? Y
N
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- By filling out and signing this application, the applicant agrees that it
will be reviewed by the club**, and whomever the club deems necessary to confer with. Upon
completion of the review of this application, the club will make the final decision as to
the admission of the applicant into the club. The applicant agrees further that he (or
she) will abide by the rules and by-laws set forth by the founders of the club, and as
amended during the course of the club's existence upon his (or her) acceptance into the
club.
- The associate membership is for all new members and is for a period of 90
days. During the 90 days the new member will be evaluated on repeater skills and
compliance with part 97 of the FCC rules before being allowed a full membership. ALL new
full memberships must be approved by a majority of club members in good standing. Not
withstanding, the board shall reserve the right to offer full membership to the associate
member who completes the probationary period. A breach of the rules by the probationary
member will mean that he/she shall forfeit the right to associate or full membership for
the period of one year at which time he/she may reapply. The associate member shall have
no voting rights. During the period of associate membership the dues will be TEN DOLLARS.
Upon successful completion of probationary period and upon being voted to a full
membership the balance of all applicable fees and dues shall be paid. If probation is not
successfully completed the associate membership fee of ten dollars will be forfeited by
the Individual.
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- I Have Read and Understand the above Terms and agree to be bound
by these rules
Signed
___________________________ Date
_____________
- Mail Application To: Mid-Island ARC P.O. 377
Mt. Sinai, NY
11766
------------------------- -------------------------Do Not Write Below
this Line---------------------------------------------------------------------
Reviewed By _________________ Position
__________________ Date _____________
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- Do not write in this box
- ____________________________________________________________________________________________
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