                  MEMBERSHIP APPLICATION FOR THE WEST GEORGIA AMATEUR RADIO SOCIETY


        Name:____________________________________________  Callsign:_______________ Class:______
 
        Address:________________________________________________________________________________
               _________________________________________________________________________________
               _________________________________________________________________________________
               _________________________________________________________________________________

	Membership Dues: Regular($15 per year)_______   Family($20 per year)_______

	If Family, Names and Callsigns of members
        1)______________________________________________________________________________________
        2)______________________________________________________________________________________
        3)______________________________________________________________________________________
        4)______________________________________________________________________________________
        5)______________________________________________________________________________________

	Contact Phone number:___________________________________________________________________

        Internet Access:  Yes / No 
        Email Address (if you have one):________________________________________________________
        Keep Email Address Private: Yes / No
        Current member of ARRL:  Yes / No  If not current, have you ever been a member: Yes / No
        Member of ARES (Amateur Radio Emergency Service):  Yes / No

        NOTES:
	Make check payable to: WGARS    Mail to:  WGARS   PO Box 1535   Carrollton, Ga.  30117

        ARRL membership can be done through the West Georgia Amateur Radio Society. If you have
        never been a member of ARRL (Amateur Radio Relay League), applying for membership through
        the West Georgia Amateur Radio Society helps the club. To maintain the special ARRL club
        affiliation, the West Georgia Amateur Radio Society will need to have at least 51% of it's
        members hold membership in the ARRL. If you are not a member of ARRL, please consider
        joining the ARRL.

	For ARES membership, contact on the W4FWD 2 Meter repeater 146.640 131.8 tome:
                Carroll County: Alan Rundell - K4DEY
                Harrellson County: Jon Mitcham - KD4YDA
                Heard County: Glenn Alford - KE4OBM