SUN CITY CENTER AMATEUR RADIO CLUB

APPLICATION FOR MEMBERSHIP

Please print

NAME: ______________________________________________CALLSIGN ______________CLASS_______

HOME ADDRESS: __________________________________________________________________________

TEL.#: ______________________CELL TEL.#:______________________CA MEMBERSHIP #_____________

E-MAIL ADDRESS: _______________________________________NAME ON CLUB ID:_________________

SPOUSE FIRST NAME: ______________________________CALLSIGN (if also licensed) ________________


ARRL Member? ____Do you have a 2 Meter HT? ____Do you have HF Radio Equipment?____

Ham Radio Interests: HF ____ CW ____ VHF ____UHF ____QRP ____Packet ____ Technical ____DX ____

Contest ____NET _____ SSTV ____ Satellite ____ RTTY _____ _ Public Service ____ Races____ Ares ____

Other ____________________


DISCLOSURE

Do you agree to the publication of your address in the Club Roster?______

Do you agree to the publication of your telephone number in the Club Roster? _____

Do you agree to abide by the Club By-Laws?_____


Signature: _____________________________________________________ Date: ____________

SCCARC meets at 2:00P.M. on the first Wednesday of the month in the Florida Room, Atrium Building in the
North Complex. Dues are payable upon receipt of this application and at the October or November meetings
for the following year.

Thank you for joining us. An ID Badge will be issued to you and a key to the radio shack will be available after
check out of our equipment.