Membership form !                                                                                                                                                                                                                    

HI, thanks for your interest in our club. If you would, please print your information on this form
and bring it to a meeting, or send it in by mail.
We hope to see you at the meetings soon!

The PARC mailing address is:

PARC

P.O. Box 2722

Pocatello, Idaho 83201

Date:  ___________________________

Name:  ________________________________

Call Letters:  __________  License class:  __________  Year First Licensed   _________

Street Address:  ____________________________________________

City, St, Zip:  ______________________________________________

Telephone Number:  ______________  Do you want your telephone No. listed on the club web site?  (Y/N)______

EMAIL address:  __________________________  Do you want your EMAIL address listed on the club web site? (Y/N)___

Secretary/Treasurerís information

Date and amount Paid:   ___________/__________

                                                        Amount                   Date

Note:   Dues are $24.00 per year for single members.  Family membership dues is an additional
$12.00 per year for all family members living in the same household
.

All members dues are due the first of January.  Dues are prorated for new members (see below)

JAN $24, FEB $22, MAR $20, APRIL $18,  MAY $16, JUNE $14, JULY $12, AUG $10, SEPT $8, ETC..

Please list any family members who would also like to join the club, their call signs and license class here: 


 

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?