PCARC Header

MEMBERSHIP APPLICATION


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 do so?    

__________________________________________________________________

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 repeaters.
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.