Name: _________________________________________ Callsign: ___________
Class of License: _________________
Address: ___________________________________________________________
City: ____________________________________________ ZIP: _____________
Telephone: ______________________ E-MAIL: ___________________________
Year your were first licensed: _______________________________
Are you currently active? _____________
Bands and modes: ___________________________________________________
Are you an ARRL member? ______________
If not, would you like to become a member? ______________
Family member name: ___________________________ Callsign: ___________
Class of License: _________________ E-MAIL: _________________________
Estero Radio Club Inc. is a registered California 501(c)(3) Non-Profit Corporation.
Make out checks to: Estero Radio Club Inc.
Print this page and mail it with your check to:
Member dues are $15.00 per year and $26.00 for two family members.
Dues are payable on January 1 each year and delinquent on April 1.
Estero Radio Club Inc.
P.O. Box 6521
Los Osos, CA 93412
You may also bring your check and application to the next meeting.