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I, Your
Name , herby apply for membership in the Dalton Amateur Radio Club, Inc.
as a "FULL" member with all rights, priviledges and responsibilities associated with the membership. I understand there is an annual dues fee of $12.00 U.S. for each year of membership. DARCI Membership Application Name :___________________________________ Spouse:________________________________ Callsign:____________________ License Class:__________________ Birth Date:____________ Address:_________________________________________________________________________ City:____________________________ State:______________________ Zipcode:_____________ Home Phone:_____________________________ Work Phone:_____________________________ County:________________________ Arrl Member ? Yes / No if yes, Arrl number_____________ E-Mail Address:___________________________________________________________________ If operating Packet, the callsign of your PBBS is:________________________________________ Emergency Power Available ? Yes / No What Bands / Modes ______________________________
I understand that the by-laws of the Dalton Amateur Radio Club, as well as duties and obligations as a member are controlled by the Dalton Amateur Radio Club and I agree to abide by them. Sign Here:______________________ Date :_______________
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Please mail to : P.O. Box 143 Dalton, Georgia 30722-0143 Whitfield County, United States
Don't forget your check or money order for $12.00 for the yearly dues ! Thank You for your interest in the DARC !!! |