Membership form !                                                                                                                                                                                                                    

HI, thanks for your interest in our club.
If you would, please print  this form and fill it in , & bring it to a club meeting , or mail it..
Hope to see you at our meetings, everyone is welcome. members and non-menbers

Our address is 

PARC 
PO Box 2722
Pocatello, Idaho 83201

Call Letters  _______________       License class________________      Year first licensed ____

Name _____________________________                Address____________________________

City, St, Zip ______________________________    
any telephone # you would like listed ________________________________

Dues are $24 a year, for the primary member,  $12 Each other family members

Please list any FAMILY members, Calls, license class  
here_

EMAIL for all members ??_______________________________________
Please  list any special interests (see below)  ,,  we are always looking for interesting 
programs for our meetings.  Could you provide a program, or do you know of any interesting
programs, or any ideas, for our meetings??

Would you like HELP, upgrading you ham license_____.

Are you a member of any of these organizations ,
or hold any of these certificates,
or have interest in these things ?
if you don't know what they are, you might want to find out ?? call an ELMER