GREEN VALLEY AMATEUR RADIO CLUB
** INDIVIDUAL / FAMILY REGISTRATION FORM **
CLUB DUES FOR YR 2012 NOW BEING COLLECTED AND ARE
** TEN DOLLARS **
MAKE YOUR CHECK PAYABLE TO "G.V.A.R.C"
PLEASE SEND THIS FORM AND YOUR-BUCKS TO OUR CLUB TREASURER
BOB CALL - KE7SBQ
Green Valley Amateur Radio Club
140 E El Viento
Green Valley, Az 85614
"I AM ADDING THE AMOUNT OF $ _________ TO OUR $10 REGISTRATION FEE
TOWARDS THE MAINTENANCE OF THE 2 METER AND 70 cm REPEATERS."
MEMBER STATISTICS
(please Print)
Name_______________________________________________
Call Sign_______________________________Class___________
Name________________________________________________
Call Sign_______________________________Class___________
Any Changes to data below
Mailing Address________________________________________
City_______________________________State_____Zip_______
Telephone Number_______________________________________
E-mail Address (s)_______________________________________