Want to become a member of East Gippsland Amateur Radio Club, all you need to do is print this Membership application form, fill it out, send to
EGARC Inc. VK3EGC
76 Langford Parade
Paynesville Vic 3880
with money order or cheque for $ 30.00 ( year membership from July ) or $ 15.00 if
applying for membership arould Dec-Jan ( Half membership to end on June )
Pension Concession Card holders have the option of paying a discounted fee of $25

Down Load Application PDF file or Word Doc file


EAST GIPPSLAND AMATEUR RADIO CLUB Inc. WIA Affiliated Club


MEMBERSHIP APPLICATION

Name _______________________________________ Callsign __________
Nominated By ________________________________ Callsign __________
Street Address _________________________________________________
Mailing Address ________________________________________________
E-mail Adderss _________________________________________________
Phone – Home __________ Business __________ Mobile_______________
Fields of employment ____________________________________________
______________________________________________________________

Qualifications
Trade ________________________________
Professional ___________________________

Areas of interest in Amateur Radio - ________________________________
______________________________________________________________
Other hobbies - _________________________________________________

WIA Member yes / no -- Wicen Member yes / no

Club membership fees are due at the AGM (July) and are payable for the period of 12 months.



Signature of Applicant __________________

Click Here To Return To Previous Page

you are visitor number Visitor Counter by Digitscopyright © MMIX. Updated Tuesday 4th of August, 2009