Application for Membership
to
NKARC
Print this form or download the files below, print and mail to the address on the form.
North Kitsap Amateur Radio Club
Membership Application/Renewal Form
Please use this form when submitting dues and mail to:
P. O. Box 2268, Silverdale, WA 98383-2268
” New Membership ” Renewal
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Name: |
Call: |
Class: (circle one)E A G T+ T N |
Date: |
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Mailing Address |
Street or PO Box: |
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City, State, Zip: |
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Home Phone: |
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Work Phone: |
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e-mail: |
ARRL Member? ” Yes” No |
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Dues: (check one) |
” Regular $15.00 |
” Senior (65 and over) $12.00 |
” Student $6.00 |
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Additional Family Members: (For family member(s) in addition to a regular or senior member) |
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Name: |
Call: |
Class (circle one)E A G T+ T N |
Dues: $10.00 |
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Name: |
Call: |
Class (circle one)E A G T+ T N |
Dues: $10.00 |
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Name: |
Call: |
Class (circle one)E A G T+ T N |
Dues: $10.00 |
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(Checks payable to NKARC) |
Total Enclosed : |
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Notes:
(1) The dues year runs from January through December.(2) Dues will be prorated at half for New Members joining after June.
Download PDF File, Here.
Download MS Word Doc File, Here