CHENANGO VALLEY AMATEUR RADIO ASSOCIATION INC.

  

Annual On-line Membership Application

 

MEMBERSHIP

TYPE

 STATUS
First Family Member Voting $25.00 Code M New Renewal
Add’l Family Member Voting $25.00 Code B New Renewal
Add’l Family Member Non Voting $  5.00 Code F New Renewal
Associate Non-voting $  5.00 Code A New Renewal
Student Through High School $  7.50 Code S New Renewal

Total of Above, $

One copy of the club newsletter, “The Bullthistle Bugle” will be transmitted electronically to each member/household unless the member is unable to receive email and /or adobe acrobat pdf files, in which instance a hard copy will be mailed. Membership runs from April 1 to March 31 of the following year.

 Callsign:        License Class : N T T+ G A E

Member Name:

AddressCity:State

ZipHome Ph Work Ph Cell

E-Mail Address

Date:

Other family members for whom this application is made:

NAME(1) CALL

MEMBERSHIP CODE       License CLASS: :N T T+ G A E

NAME(2) CALL

MEMBERSHIP CODE:       License CLASS: : N T T+ G A E

To help us get to know you better, please answer the following; check all that may apply:

 

 

 

  

Memberships

    
           
ARRL MEMBER RACES Member QCWA Member
ARES Member SKYWARN Member X-10 Member
    Volunteer Examiner    

 

      Operating Interests    
           
LF/HF Bands HF/UHF/SHF Bands QRP/Low Power
SSB/AM/FM CW/RTTY/PSK31 SSTV/ATV
Satellites/Moonbounce Dxing/Contesting Ragchewing
Building/Experimentation Portable Packet Portable PSK31
Mobile Capabilities - HF/VHF/UHF Own a computer    

 

Membership Interests

Licensing Instructor  Field Day-Setup/Operating Public Service Nets
ARES Net Control/Skywarn  Public Relations Committee Publicity Committee
Club Archives/Historian  Newsletter Technical Committee
Membership Committee UNYREPCO Liaison Youth Groups (Scouts, JOTA)
  Elmering

If there is something that you would like us to know that is not listed above, kindly put it in the text box below.

Please Make All Checks Payable to CVARA, Inc and Send Payment to:

Ray Darling, K2DAR

695 Ives Settlement Rd.

Bainbridge, NY 13733-3350

 

 Email: k2dar@arrl.net

The above information will only be used for official CVARA use only. No information will be used for or divulged to the general public in any manor

CVARA: Mem App (Ed. 04.06.07)