AREC Repeater Group, Inc.

Membership Application

First Name ________________________________________________ MI _____

Last Name _________________________________________________________

Call Sign _________________________ ARRL Member? _______ (Y/N)

Address ____________________________________________________________

             ____________________________________________________________

City ____________________________________________

State __________________ Zip _________________

Phone __________________________________________

Email ________________________________________   (for newsletters and announcements)

Other licensed family members in same household

Name                                                     Call sign

________________________________________________

________________________________________________

________________________________________________

________________________________________________


Please make check for $20 payable to:    AREC Repeater Group, Inc.

and mail to:


AREC Repeater Group, Inc.
PO Box 7623
West Palm Beach, FL
33405-7623

You will receive an information packet by US Mail with instructions and access codes.
Thanks, and
"73"