Membership Application

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

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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 email confirming your payment and membership.

Thank you for your support!