APPLICATION FOR M.A.R.C. MEMBERSHIP
Name
_______________________________________ Email Address________________________________
Street Address____________________________________________
Phone___________________________
City_____________________________ State_______ Zip Code____________ Birth
Date________________
Call:_______________________________________________ Previous
Call:__________________________
Member of ARRL Yes ( ) No ( ) Date of last upgrade___________________ Date first
licensed_________
The following would help the Club do a better job for you.
Type of Programs Wanted___________________________________________________________________
Type of Activities interested
in________________________________________________________________
General comments that might be helpful to the
Club._____________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Check one of the following:
( ) Full Membership -- $15.00 per household effective starting 2ии8
( ) Associate Membership -- $5.00 Lives outside of Kearney area and/or is fulltime member
of another club.
Date applied for membership____________ Date Approved___________.
Date Paid Dues______________ Check ##_________ Cash__________
Secretary Treasurer’s initials__________ President’s initials___________
Please mail to: M.A.R.C. PO Box 1231, Kearney, NE 68848-1231.