RADIO ASSOCIATION OF WESTERN NEW YORK MEMBERSHIP APPLICATION

RADIO ASSOCIATION OF WESTERN NEW YORK APPLICATION FOR MEMBERSHIP

NAME: ___________________________________ CALL: ______________ DATE: ______________

ADDRESS: ________________________________

CITY: ____________________________________ ZIP: _____________

EMAIL ADDRESS: _______________________________

HOME PHONE #: _______________ Check here: _____ If you DO NOT want number put on club roster.

OCCUPATION: _____________________________ AGE: __________ (Optional)

CLASS OF LICENSE: ________________ DATE FIRST LICENSED: _________

Present Equipment: _____________________________________________________________________________
_____________________________________________________________________________________________

Check any particular interests: CW_____ PHONE _____ RTTY _____ TV: sstv / atv MOBILE ______

SATELLITE _____ TRAFFIC NETS _____ ANTENNAS ______ CONSTRUCTION _____

DX _____ COMPUTERS _____ PACKET _____ OTHER ____________________________

******************************    The undersigned hereby makes application for membership in the RADIO ASSOCIATION OF WESTERN NEW YORK and includes herewith the sum of $__________. * (See note below).
   This shall constitute full payment of dues for the year SEPTEMBER FIRST _________ to SEPTEMBER FIRST of the following year upon acceptance of the Board of Directors.
   If accepted into membership, the undersigned agrees to abide by the By-Laws, rules, and regulations; and shall, to the best of his/her ability, work towards the advancement of Amateur Radio in this area.

APPLICANT'S SIGNATURE: ___________________________ Recommended by: _______________________

Executive Approval: ________________________ Date: _____________

                 Annual Dues:      $15.00 Individual Member                         DUES ARE DUE FOR ALL MEMBERS
                                             $20.00 Husband/Wife (Family)                  ON SEPTEMBER FIRST OF EACH YEAR
                                              $ 7.50 Student (Full Time)

*There is an adjustment to the dues of NEW members joining after January 31^st.

Make check payable to: RAWNY                      Send to Treasurer:     Al Minklei, KA2ORB
                                                                                                                   3427 Stoney Point Road
It is not necessary to be licensed                                                            Grand Island, NY 14072
to be eligible for membership.