Application for Membership
Rip Van Winkle Amateur Radio Society (RVWARS)
Name
*
Prefix
First Name
Middle Name
Last Name
Suffix
Call Sign
License Class
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Approximate Birth Year
Current Memberships
ARRL
ARES
RACES
SKYWARN
Committee Interests
Technical
Education
Field Day
DX
Contesting
Public Service
Publicity
Hospitality
Other
Interests & Comments
Annual Dues Levels
Individual $25
Family $30
Student $5
Active Military FREE
New Membership?
New Membership
Membership Renewal
Other
I prefer to submit any Annual Membership Dues I may owe via:
PayPal (see below)
In Person at a Club Meeting
Via Check sent to: RVWARS, PO Box 96, East Chatham, NY 12060
Other
Annual Dues via PayPal
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( X )
USD
Annual Dues (See "Annual Dues Levels" above. Please use Friends & Family for PayPal or add $2, and thank you.)
I hereby agree to abide by the Constitution and By-Laws of and all the rules and regulations enacted by the Rip Van Winkle Amateur Radio Society.
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