Welcome to K5TYR, The Tyler Amateur Radio Club

 

MEMBERSHIP APPLICATION / RENEWAL FOR THE

TYLER AMATEUR RADIO CLUB, INC.

 

I hereby apply for membership / renewal in the Tyler Amateur Radio Club.  Single full membership: $25.00, additional family members $12.50 each.  Single associate membership: $25.00, additional family members $12.50 each.  Please print or type all information clearly.  Dues are prorated by quarter for new members starting with June 1st. (June-Aug $25.00, Sept-Nov $20.00, Dec- Feb $15.00, Mar-May $7.50)

 

See club by-laws for definition of club membership.  Mail to:

 

Tyler Amateur Radio Club, Inc.

P.O. Box 6393

Tyler, Texas 75711

 

Name____________________________________________ Call Sign_______________ DOB________________

 

Address____________________________________________________________________________________

 

City____________________ Zip__________________ Class of License (if licensed) ________________________

 

Home Phone______________________________ E-Mail Address_______________________________________

 

Work Phone______________________________ Cell Phone___________________________________________

 

Additional Family Member (s):

 

Name____________________________________________ Call Sign_______________ DOB_________________

 

E-Mail address____________________________________ Class of License (if licensed) ______________________

 

Work Phone______________________________ Cell Phone____________________________________________

 

 

Name____________________________________________ Call Sign_______________ DOB__________________

 

E-Mail address____________________________________ Class of License (if licensed) ______________________

 

Work Phone______________________________ Cell Phone____________________________________________

 

 

Name____________________________________________ Call Sign_______________ DOB__________________

 

E-Mail address____________________________________ Class of License (if licensed) ______________________

 

Work Phone______________________________ Cell Phone_____________________________________________

 

 

Member of ARRL? Yes___ No___

 

Check what areas of amateur radio you are interested in:

 

VHF/UHF___      HF___            Packet___             Satellite___           SSTV___               CW___

 

Emergency Communications___       Other_______________________________________

 

Do you currently receive the GroundWire newsletter via e-mail? Yes___ No___

 

If not, would like you like to be added to the mailing list? Yes___ No___

 

Please star (*) any information that you do not want published in the club directory distributed to club members.