W9AB

Membership Aplication

Name_______________________________________________Call_____________License Class__________________

Address_____________________________________City_______________________State_________Zip___________ E-Mail Address_____________________________________Occupation______________________________________ Phone ()______________________________Alsternate()__________________________________

As a member of MARC, you will be expected to abide by the Club’s Constitution and Bylaws, attend and support the Clube’s activities and volunteer your services and expertise to the benefit of the Club’s goals.

Dues are $25.00 per year and are based upon membership from January 1st thru December 31st of each year.

New member's dues will be prorated from the month they join thru the end of that calendar year.

Renewing members pay for the full year. Additional memberships in the same household pay $2.00 each.

The club newsletter, Marc Sparks, will be e-mailed to each member monthly unless you don’t have a computer, it will be mailed.

Background Information

ARRL Membership: (MARC is an ARRL affiliate and special service Club) Yes___No___; Life Member Yes___ No___

Are you an Accredited Volunteer Examiner?Yes___No___; If you are not a Volunteer Examiner and are Advanced or Extra Class, would you be willing to become a Volunteer Examiner? Yes___No___

As a member of MARC, I would be willing to serve on the following committees: Christmas Party_____________ Field Day____________Nominations____________Picnic____________

When called upon, I would prefer to serve MARC in the following office/activity:President_____Vice President______ Secretary___________Treasurer____________Board Member____________

How did you hear about MARC: Friend______Internet_______Repeater________Hamfest_________Other________

Make checks payable to MARC or Michiana Amateur Radio Club, Inc. Please return this form and check to the club treasurer at our Social meeting or mail it to:

Michiana Amateur Radio Club, Inc. P.O. Box 6012 South Bend, IN 46660