BCARC Online Application

Bledsoe County Amateur Radio Club

Membership Application
Full Name:

First Name:Last Name:Call Sign/ If Applicable:
Date*

MonthDayYear
Date
License Class, if applicable:
Phone Number*
Email Address*
example@example.com
Address (Primary Residence): *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you currently an ARRL Member?*

YesNo
Are you a Responder in Bledsoe County? If so, which department?:
Club Activity Interests:

Volunteer Examiner (VE)Emergency Communications (EmComm) Team (Must be a Bledsoe Co resident or live within 30 minutes away)
Membership dues are ONLY collected upon attending the first meeting, which can paid by cash, check, or Paypal (BledsoeARC@gmail.com). If applying after October 31st of the current year, the dues will count towards the upcoming year's dues.

Dues rates are as follows:
$15.00/year for licensed Hams.

$5.00/year for any unlicensed members.

$25/year for Family Membership, up to 4 members; additional family members are $10 each.
***Attending one monthly meeting and paying dues is required to receive
membership.***

By clicking "Submit" you have filled out and reviewed the information.
Should be Empty:

Bledsoe County Amateur Radio Club