Yes, I / We wish to belong to the:
Blue Mountain Amateur Radio Club.
Today's Date: ____________________ *please check the appropriate box below*
[] New
[] Renewal
[] Associate membership (Not Licensed)
Please check the appropriate box
Personal Information:
Name:____________________________________
Call sign:__________________________________
License status:
Basic [] , Advanced [] , 5wpm [] , 12wpm []
Additional family member(s):___________________
Call sign(s):________________________________
Relationship:_______________________________
Mailing address:
_________________________________________
City/Town:_________________________________
Prov/State:_________Postal Code:______________
Home Phone:_________________
Email:____________________________________
If you do not want your phone number(s) posted in
the Newsletter check here: []
Operating interests: (Cheek all that apply)
HF: CW [] , SSB [] , RTTY [] , PACKET [] , ATV []
VHF/UHF: FM [] , PACKET [] , EME [] , ATV []
SSB [] , SATELLITE [] , OTHER []
What club activities are you interested in:
[] Serving on a Committee / Executive
[] Field Day Activities
[] Emergency Communications / ARES
[] Scanner / Short Wave Listening
[] Community Service
[] Teaching Amateur Radio Course
[] Field Trips
[] Computers
[] Other:__________________________________
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MEMBERSHIP FEE STRUCTURE: $ 25.00 per year for first member.
Additional family memberships @ $5.00 each.
Total Enclosed...............................$_________
Please make cheque payable to:
Blue Mountain Amateur Radio Club
P.O. Box 273, Collingwood, Ontario L9Y 3Z5
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MEMBERSHIP AGREEMENT
All members, including licensed family members,
are required to sign this form I indicating their
willingness to abide by this membership agreement:
I / We agree to abide by the rules and regulations
of the Blue Mountain Amateur Radio Club and
to keep all repeater codes confidential.
I / We Understand that the VE3BMR repeater
is for the convenience of members and that there is no
guarantee of their availability at any given time.
Date _________ / _________ 2000
_________________________________________
Signature:
_________________________________________
Additional Family Member(s) Signature:
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