BRARS Membership Application Form
B.R.A.R.S. Member Application Form
Blue Ridge Amateur Radio Society Inc. CARD Number:
(For Club Use Only)
PO Box 6751 Note: Please include a self photo for the roster and your photo Id card if you have one. If you would like your Id card laminated, please include your signature on a blank white index card.
Greenville SC 29606
http://www.brars.org
Name: Initial: Last:
Call: Name you use on the radio:
Mailing Address Information:
Street1: City:
Street2: State: Zip Code:
Phone Numbers and eMail Information:
Home: Work:
Mobile: Pager:
Email:
FCC License / ARRL / Birthday Information:
Class: Expiration Date:
ARRL Member: Yes No Birthday:
Application Type Information:
$20.00 Full Member
$15.00 Full Member (over 65)
$10.00 Family Member
$10.00 Associate Member
If accepted, I agree to abide by the Constitution and By-Laws of the Blue Ridge Amateur Radio Society. You will need to sign here when voted into the club.


Signature:
Sponsors: (Two BRARS Club Members):
Call: Name:
Call: Name:
For Club Records:
Date:

Secretary: