Name __________________________________ Call Sign __________________
Address _______________________________ Telephone __________________
City __________________________________ State _______ Zip _____________
Email Address: ______________________________________________________
(Please circle one:) I do / do not want to join the club email mailing list.
The following dues apply: (check one)
_____ $12.00 Single Membership
_____ $6.00 Student or Senior Citizen
_____ $18.00 Family Membership
What office would you be willing to hold, if called upon to
If family membership, include the names (and calls) of your family.
Please make checks payable to PCARC.
Send to PCARC at PO Box 1061, Valparaiso, IN 46384
Regular membership: $12.00 Includes full use of all
Family membership: $18.00 A family is defined as a man and
woman and any minor children they may have still living with them.
Junior membership: $6.00 A junior is defined as age 18 and
under or if a full time student, 21 and under.
Senior membership: $6.00 A senior is defined as age 65 and
over, or if retired, 55 and over.