Membership Form – Keweenaw County Repeater Association. Inc. "W8FWG"

Name *

First

Middle

Last

Call Sign *

Amateur Class *

Family Call Signs

Name, Call Sign, (N,T,G,A or E)

Phone *

Email *

Would you like to be on an E-Mail listing to receive club information and updates?

STREET ADDRESS: *

City: *

State: *

Zip Code: *

Membership Type *

Balance of 1st year is FREE for new members.

Donation

Total Payment

Please add $1 it you are using PayPal. If you are making a Donation, please omit the $1 service fee.

Payment Type

Please mail payment to: KCRA Treasurer 59897 Apple St. Allouez, MI 49805. Please make checks payable to: KCRA,Inc.

Check #

ARRL Member?

Comment or Message

---OPTIONAL--- AUTOPATCH AUTODIAL SLOTS-- I prefer telephone number(s) & 2 digit autodial slot(s) on the “315” repeater (Speed Calling).

I understand that I can obtain two of these slots only if they are not already assigned.

Membership Year

Memberships are 01/01-12/31.

Date *

QUESTIONS?: Call or email Bill LaBell (KD8JAM) at (906) 337-2546 or kcra@arrl.net