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San Fernando Valley Amateur Radio Club
P.O. Box 280517
Northridge, CA 91328-0517

Membership Form
 Please fill in and click "Submit" at the bottom of the page.
If filling out by hand, press Ctrl+P or File, Print, please PRINT CLEARLY!
We need each and every member to fill out this form for our records.
Please make checks Payable to the "San Fernando Valley ARC."
Thanks de The Membership committee 2012 @ SFVARC.

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 Year First Licensed:Include in Roster
Former Calls:Include in Roster
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Cell Phone:Include in Roster
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 Volunteer to be an Elmer:Include in Roster
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RADIO INTERESTS
(Please check all that apply)
DXCWPHONERTTYPSKATV
 EMERGENCY NETS
 VHFUHFNETSCONTESTS ANTENNAS
 SATSEMEBUILDING
 OTHER

DUES INFORMATION

ARRL Member
 Full Year (January - December) - Regular Member - $18.00
 Full Year (January - December) - Family or Junior (under 18 years of age) Member - $6.00

 April - July Regular Member - $12.00
 April - July Family or Junior (under 18 years of age) Member - $4.00

 August - December Regular Member - $6.00
 August - December Family or Junior (under 18 years of age) Member - $2.00

122211-B