Amateur Radio Society of India - VU2ZH MEMBERSHIP APPLICATION FORM

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Member Society of the International Amateur Radio Union - Region 3 since 1958
The National Association of the Radio Amateurs in India since 1954

Email *

Mr/Mrs/Ms/Dr/Er Etc.

Amateur Radio Callsign *

Name of the Amateur Radio Operator *

Full Postal Address
(NOTE: This will be used for mailing the Membership Card for Life Members & other postal communication) *

City *

State *

PIN Code *

Mobile Number
(Note: This number will be used to add the applicant to the ARSI Members Group on WhatsApp - for Official announcements and ARSI Related information - Read ONLY) *

Additional Contact numbers

Email ID
(This will be used for creating your Webpage login, Groups.io invite and all other ARSI Notifications - including AGM Notices, etc.) *

Licence No. *

Valid Upto *

YYYY

Previous Callsigns Held (If Any)

Date of Birth *

YYYY

Membership Applied for *

Life Member (Rs. 4,000 .00)

10-Year Membership (Rs. 2,000.00)

5-Year Membership (Rs. 1,100.00)

Annual Membership (Rs.250 subscription + Rs. 50 joining fees)

Institutional Membership (Rs. 10,000)

Patron Member (Rs. 25,000)

Payment Details *

Cheque

UPI (ARSOFINDIA@SBI)

QR Code Transfer (Scan using any online payment app - see below)

QR Code for Only Payment Apps

REMEMBER: to take a screen-shot of the payment confirmation ,

Declaration *

By submitting this Google form, I declare that the information that I have provided is correct and shall be used by Amateur Radio Society of India for registration of Membership as per the above selected category

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A copy of your responses will be emailed to the address you provided.

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