Any person who submits an application complete with the
signatures of two sponsoring Full Members of the club
shall be accepted for the appropriate type of membership.

BARC Membership Application

Full Name: ________________________________________
Amateur Radio Callsign: ____________
Mailing Address: ________________________________________
City: ________________________________________
State: ______
Zip Code: ____________
Telephone Number: (______) ______-________
E-Mail Address: ________________________________________
License Expires: ____________________
License Class: ___Novice ___Technician ___Technician Plus ___General ___Advanced ___Extra
ARRL Member: ___Yes ___No
Sponsors’ Call: ____________ & ____________

Mail To:

Blackford Amateur Radio Club
P.O. Box 282
Hartford City, IN 47348

Or bring this to our monthly meeting which is held on the third Thursday of the month at the Hartford City City Building.
 

Updated 01/11/2010 21:52:07