GREEN VALLEY AMATEUR RADIO CLUB

** INDIVIDUAL / FAMILY REGISTRATION FORM **

CLUB DUES FOR YR 2017 NOW BEING COLLECTED AND ARE

** TEN DOLLARS **

MAKE YOUR CHECK PAYABLE TO "G.V.A.R.C"

PLEASE SEND THIS FORM AND YOUR-BUCKS TO OUR CLUB TREASURER

BOB CALL - K7RWC
Green Valley Amateur Radio Club
501 S La Posada Circle #195
Green Valley AZ 85614

"I AM ADDING THE AMOUNT OF $ _________ TO OUR $10 REGISTRATION FEE
TOWARDS THE MAINTENANCE OF THE 2 METER AND 70 cm REPEATERS."

MEMBER STATISTICS

(please Print)

Name_______________________________________________

Call Sign_______________________________Class___________

Name________________________________________________

Call Sign_______________________________Class___________

Any Changes to data below

Mailing Address________________________________________

City_______________________________State_____Zip_______

Telephone Number_______________________________________

E-mail Address (s)_______________________________________