WAARCI Version 3

New Member Application

Complete this secure online form to request membership in WAARCI. A PDF copy is generated for club review.

Application and license information

Application typeLicense classApplication dateCall sign

Applicant information

Full nameStreet addressCityStateZIP codeZIP +4Email addressPhone numberDate of birthARRL memberSpouse nameSpouse call sign

Family membership information

Add family members living in the same household.

Family member 1

NameCall signLicense classDate of birthRelationship

Family member 2

NameCall signLicense classDate of birthRelationship

Family member 3

NameCall signLicense classDate of birthRelationship

Family member 4

NameCall signLicense classDate of birthRelationship

Membership rate

Single membership
January-December: $12.00Single membership
July-December: $6.00Family membership
January-December: $18.00Family membership
July-December: $9.00

Notes

Verification code: 62REWAType the code shown above

I understand that I must print and bring the completed PDF to a WAARCI meeting and pay the selected membership fee. I confirm the information is accurate and consent to its use for club administration.