W2QW Membership Application

Membership Application Process:

The application process requires a prospective member to be sponsored by at least one active member of the club. It is the sponsor’s role to provide information regarding the club (including the membership application process), answer any initial questions the applicant my have about the club, and get to know a little about the applicant so that they may speak on their behalf to the general membership.

Once the applicant has obtained a sponsor this application form can be completed.

The annual membership dues are currently $48.00 per year for both Regular and Associate membership.

Regular Membership:

Regular members are expected to attend at least two meetings during a six-month period, as well as participate in the annual Hamfest in June.

Associate Membership:

Associate membership has no meeting attendance requirements and Hamfest participation is not required but is of course welcomed and encouraged. Additionally Associate Members do not have voting rights.

Today's Date

Transaction Date

Type of Membership

New Regular MembershipNew Associate MembershipRenew Your MembershipUpdate Membership Info Only

FCC License Class

Your Call Sign

Name

First NameLast Name

Email Address

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Sponsor #1 Name

Sponsor #1 Call Sign

Have you ever been denied a license ?

YESNO

If you answered YES to the above question, please explain why you were denied a license.

List of other call signs you hold / have held:

List the bands and modes you operate on :

Why do you want to join W2QW the Raritan Valley Radio Club ?

What other radio clubs do you belong to ?

What committees would you be interested in serving on ?

Employers Company Name

Job Title

Are any of your family members licensed hams ?

YESNO

If you answered YES to the above question, please give their call signs and relationships:

Has your sponsors explained to you the requirements of being a member of W2QW?

YESNO

What other hobbies or interests do you have ?

Comments, suggestions or any additional information you would like to tell us.

W2QW MEMBERSHIP

Regular Membership

$48.00 Quantity

Associate Membership

$48.00 Quantity

Membership Renewal

$48.00 Quantity

Total

$0.00

Are you paying with ?

Credit CardCheck

Pay With Check

Please enter your check number here for our reference

Payment by check:

Be sure to put your call sign on the info portion of your check and on the return address of your mailing envelope.

Make your check payable to : "Raritan Valley Radio Club".

Mail your check to :

W2QW
C/O Mike Christiansen
407 Bunker Hill Rd.
Princeton, NJ 08540

Pay with Credit Card