|
PLEASE complete a membership form for all new/renewal members.
Name: ______________________________________ Date: __________________
Call sign: ________________ Class [ Ex Adv Gen Tech Nov]: ___________
Street Address: ______________________________________________________
City, State, Zip: ____________________________________________________
Home phone: _____________________ Work phone: _______________________
ARRL Member? ____________________ Email: ____________________________
Preferred modes: (e.g. HF-SSB/VHF/QRP/Other): ________________________
Be an Elmer for new hams with: _______________________________________
Special topics of interest / suggestions for FARS meeting speakers:
______________________________________________________________________
Badge $9 [Clip / Pin / Magnetic] (circle choice)
Badge Name: ________________________________ Amount: ________________
Dues: ________________
Donation (optional): ________________
Total: ________________
Dues: $15 [regularly $20].
Send your check payable to FARS to:
FARS
436 Memphis Drive
Campbell, CA 95008
Please note:
Membership runs for one year from January 1st through December 31st.
New membership applications accepted later in the year may have
their dues prorated (see dues schedule).
A Badge for a new member, or a replacement badge,
is $8 ($9 magnetic).
Your call sign and "badge name" (eg "Dick" for Richard)
as specified above above will appear on the badge.
We will use your first name if no "badge name" is specified.
Badge orders are not shipped, so they must be picked up
at a membership meeting.
Use this form to become a member of FARS,
or to renew membership.
Renewing members, or badge only orders, should provide at least
their name, call, and the date.
Also include any information that may have changed.
Put "N/A" where you wish to remove (or not provide) information.
Foothills Amateur Radio Society is recognized
as a 501(c)(3) non-profit under the Internal Revenue Code
and is also recognized by the California Franchise Tax Board.
This means that your Dues and any additional donation are
fully tax deductible on your Federal and California Tax returns.
|