I __________________________________________________, AMATEUR CALL ___________________________
DO HEREBY APPLY FOR ________________________________ MEMBERSHIP IN THE COAST AMATEUR
RADIO ASSOCIATION.

AN INITIATION FEE OF $20.00 AND DUES OF $_____________ ARE HEREBY INCLOSED WITH
THIS APPLICATION.

I HEREBY PROMISE TO ABIDE BY THE CONSTITUTION AND BY-LAWS OF THE COASTAL
AMATEUR RADIO ASSOCIATION.

SIGNED: _____________________________________________
DATE: _______________________________________________

PROPOSED FOR MEMBERSHIP BY: _____________________________________________________________
DATE: _____________________________________________________________

APPLICANTS ADDRESS:________________________________________________________________________________
PHONE NUMBER :(_______) ___________-____________
EMAIL ADDRESS:___________________________@__________________

This form can be printed and mailed to the above address, or brought to a quarterly meeting. Quarterly meeting dates are posted at www.whitehallrepeater.com

APPROVED AS MEMBER DATE: _________________________________________________________________