AREA REPEATER CLUB - On line application

On line application

A.R.E.A. MEMBERSHIP APPLICATION

*CALL SIGN *LICENSE CLASS *YEAR LICENSED *MEMBERSHIP OPTIONS *FULL NAME *ADDRESS APT. # *CITY *STATE *ZIP *HOME PHONE WORK PHONE *DATE OF BIRTH *OCCUPATION *WHAT MODES DO YOU WORK FAVORITE MODE AND BAND *ANY FCC VIOLATIONS (PENDING OR PAST) IF YES EXPLAIN
OTHER HOBBIES OR INTEREST
SPOUSE NAME SPOUSE'S CALL SPOUSE'S BIRTHDAY WHO WERE YOU REFERRED BY

By submiting this form you certify that the above information is correct. You understand that this application will be presented to the membership of the Amateur Radio Experimmenters Alliance for approval.You also understand that you must abide by the rules and regulations governing amateur radio as prescribed by the F.C.C. and the By-Laws of the Amateur Radio Experimenters Alliance. Failure to do so may result in the termination of your membership in the Amateur Radio Experimenters Alliance.

*DUES PAYMENT