MEMBERSHIP APPLICATION FORM
Fill out this Cocoa Amateur Radio Society Membership Application Form, submit it, then bring your check (or Cash) to the next club meeting.
Check the home page for the next club meeting time and date
Please provide the following Contact Information
Select CARS Membership Type for which you are applying:
Are you a member of the Amateur Radio League?
Have you held other Amateur Radio Call Signs? If so please list them.
In what Year did you receive your Amateur Radio License?
Is your Membership being sponsored by a CARS member? If so please enter
the members Name and Call Sign.
Other information you would like to share with the club:
I can now or will soon be able to operate on the following Frequencies:
160 meters
80 meters
40 meters
30 meters
20 meters
17 meters
15 meters
12 meters
10 meters
6 meters
2 meters
70 CM
Do you have a 2 meter Hand Held Transceiver (HT)? YES NO
Are you a member of ARES or RACES? YES NO
Would you want to help with Public Service Events? YES NO
Would you help with emergency communications such as shelters? YES NO
Do you have an ARRL ARECC Level 1, 2, 3 Certification card. YES NO
If yes what Levels were you Certified for?
CARS Dues for Month Membership Application Submitted
| MEMBERSHIP TYPE |
YEARLY |
| FULL VOTING MEMBERSHIP |
$10.00 |
| FAMILY MEMBERSHIP |
$5.00 |
| JUNIOR MEMBERSHIP |
$10.00 |
| SNOW BIRD MEMBERSHIP |
$10.00 |
| ASSOCIATE MEMBERSHIP |
$10.00 |
You may send your application and check for your membership Dues to:
Cocoa Amateur Radio Society
1150 West King St
Cocoa, Florida 32927
When you click "Send It", you will see a message asking if you want
to continue. Click "OK" then click "SEND" for Your e-mail program
to send your
information.
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Revised 11/03/11 Web page by Glenn Edmondson
