Overlook Mountain Amateur Radio Club Membership Application Form

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Email *

I / We wish to belong to the Overlook Mountain Amateur Radio Club *

New

Renewal

Membership category *

Full voting membership ($35/year)

Senior, same privileges as Full voting member (65 or older) ($30/year)

Family membership, multiple members (Full, Senior) in same household ($45/year)

Name *

Callsign

License class

Address

Cell phone *

Are you a member of the ARRL?

Yes

Clear selection

Operating interests (all that apply)?

SSB

RTTY

PACTOR

PSK31

VHF/UHF FM

Satellite

Mesh

Other:

What club activities are of interest (all that apply)?

Emergency Communications – ARES / RACES

Teaching Amateur Radio Courses

Field Day

Fox Hunts

Community Service

Internet Technology

Hamfests

Volunteer Examiner

Serving on a committee

I / we, agree to abide to the constitution and by-laws of the Overlook Mountain Amateur Radio Club. I/we further agree to abide by all FCC rules and procedures as well as the directions of the station trustee and/or control operators designated by the club pertaining to the use of repeaters or other club equipment. I/we understand that the WA2MJM repeaters are operated for the convenience of members and that there is no guarantee of their availability at any given time. Additionally, I/we understand that repeated and or major infractions of any of the above agreed to stipulations will potentially result in loss of membership in the club and forfeiture of any dues paid. *

Agree

Disagree

Send me a copy of my responses.

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