Muscle Shoals Amateur Radio Club
Membership Application
Address:_____________________ Phone Number:__________________
City ____________________ Zip Code: ______________
Email Address ______________________________________________
Circle the bands/modes you operate on:
160 80 40 30 20 17 15 10 6 2 220mHz 440mHz
CW SSB AM FM RTTY PACKET AMTOR SSTV ATV OSCAR
OTHER MODES:_________________________________________________
ARRL STATUS: Member____ Non-member ______Lifetime Member___
Please list on the back any contests, nets, awards, programs, or other special activities you are interested in:
What club
activities would you be interested in participating in?
Membership Commitment Statement:
I, ______________________________, by my signature request membership in the Muscle Shoals Amateur Radio Club. I further agree to abide by the Federal Communications Commission Rules, as they pertain to the Amateur Radio Service, and to the bylaws set forth by this club. I also agree and understand that any action on my part to disrupt or interfere with the communication of others, or misuse club repeaters or equipment will result in the immediate termination of my membership.
Signed: _________________________________ Date:_______________________
Dues are $20.00 annually $30.00 annually for couples.