Delaware Amateur Radio Associa on (DELARA)

Membership Applica on

Name: ___________________________ Call: _____________________ Class: _____________________

Spouse: ___________________________ Call: _____________________ Class: _____________________

Address: ______________________________________________________ City: ______________________

State: ________________ Zip+4: ___________________________

Home Phone: (_____)____________ Business Phone (_____)____________ Cell Phone (_____)____________

E‐mail: _____________________________________________________________________________________

Spouse E‐mail: _______________________________________________________________________________

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Other family member(s) who are licensed hams at the same address: (Non‐Vo ng Members)

Name: _____________________________ Call: ____________________ Class: ____________________

Name: _____________________________ Call: ____________________ Class: ____________________

Name: _____________________________ Call: ____________________ Class: ____________________

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Please check if you are a member of:

ARRL ARES/RACES NTS MARS SATERN CERT Red Cross

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Please indicate your areas of interest:

Teaching Ham Classes Contribu ng to the Newsle er Field Day Project Bldg.

Being an Elmer Publicity/Public Rela ons Contes ng MESH

Technical Assistance Traffic Handling (NTS) DX Search/Rescue

So ware Development ARES/RACES CW Solar Ac vity

RFI/TVI Social Events Antenna Design Digital Modes

Direc on Finding/Tracking Emergency Communica ons Internet Linking QRP

Dues:

Regular Member (Vo ng) = ___________________

Family Member or Spouse (Non‐Vo ng) = ___________________

Associate Member (Non‐Vo ng) = ___________________

Op onal Dona on ___________________

$20.00 each x ______

$2.00 each x ______

Total:

___________________

Pay dues with PayPal! Send to: dues@k8es.org

Please make check payable to DELARA and return to the club treasurer. If you have any ques ons, please call (740) 972‐3723.

Ken Bird, W8SMK

244 N. Parkway Dr.

Delaware, Ohio 43015