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Membership Form
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Santa Fe Amateur Radio Club (SFARC)
P.O. Box 22091
Santa Fe, NM 87502
Website: http://www.w5sf.com/

This space for SFARC use only

Month/Year: _________

Amt: _________________

Receipt Sent: ________

I am a new SFARC Member
Yes ______ No ______

(If you would like to receive a receipt indicating the amount that you paid please check here )

Primary Member Name / Callsign ____________________________
ARRL MEMBER?: _____

Mailing Address___________________________________________

City State Zip _____________________________________________

Telephone (___) - ________*E-mail Address ___________________

Status: (Please check the appropriate space to the right)

Single___($25) Student ___($15) Family ___ ($35)

Family Member Name(s) / Callsign(s) for Family Memberships:

(1)_______________________________________________________________ARRL MEMBER?: _____

(2)_______________________________________________________________ARRL MEMBER?: _____

(3)_______________________________________________________________ARRL MEMBER?: _____

(4)_______________________________________________________________ARRL MEMBER?: _____

(5)_______________________________________________________________ARRL MEMBER?: _____

(6)_______________________________________________________________ARRL MEMBER?: _____

Are you or a member of your family a Volunteer Examiner (VE)?

Yes ____ No ____ And if so, what is your VEC (ARRL, W5YI...) ____________

Would you like to know how to become a VE? Yes _____ No ______

Are you interested in helping with any of the following:

Field Day_________ Special Events_______ Social Events _______

Public Service _______ Other _____ Describe:____________________________________________

 

Comments / Suggestions:

_____________________________________________________

_____________________________________________________

_____________________________________________________

*In order to save the cost of Postage the SFARC will e-mail the Club Newletter; however, if you would like to receive the Club Newsletter via the Postal Mail please check here _____. We will accommodate your request.

Annual dues are $25 for Single, $15 for Student, or $35 for Family. Please complete the form and mail to the club address listed at the top of this form or give to a club officer. Thank you for supporting your Santa Fe Amateur Radio Club. This Club supports the various repeaters located on Tesuque Peak, Elk Mountain and at the St. Vincents Hospital in Santa Fe, NM. The SFARC also meets at the Pantry Restaurant in Santa Fe at 5th Street and Cerrillos for Breakfast every Saturday Morning at about 7:00 AM - feel free to join us.