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

Name:

Call:

Class: (circle one)

E A G T+ T N

Date:

Mailing Address

Street or PO Box:

City, State, Zip:

Home Phone:

( )

Work Phone:

( )

e-mail:

ARRL Member? ” Yes

                                ” No

Dues:

(check one)

” Regular $15.00

” Senior (65 and over) $12.00

” Student $6.00

Additional Family Members: (For family member(s) in addition to a regular or senior member)

Name:

Call:

Class (circle one)
      E A G T+ T N

Dues: $10.00

Name:

Call:

Class (circle one)
        E A G T+ T N

Dues: $10.00

Name:

Call:

Class (circle one)
        E A G T+ T N

Dues: $10.00

(Checks payable to NKARC)

Total Enclosed:

 

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