2016 MEMBERSHIP APPLICATION
                        
Date of Application ____/_____/____

Primary member_________________________________
Call Sign______________Class_____

Family member__________________________________
Call Sign______________Class_____

Family member__________________________________
Call Sign______________Class_____

Address_____________________________________________________________________

Phone________________________Email______________________________________

Member of ARRL?
                             Life    ____YES   ____NO 
           
                         Regular  ____YES______NO

Are you VE Certified?   _____YES______NO

Indicate level of membership:
_____Rejoining member                                          $20.00
_____Rejoining member plus one family member      $24.00
_____Rejoining member plus two family members    $28.00

New Member as of:
_____January 1 through March 31               $20.00
_____April 1 through June 30                      $15.00
_____July 1 through September 30              $10.00
_____September 1 through December 31    $  5.00

New Member plus 1 family member as of:
_____January 1 through March 31               $24.00
_____April 1 through June 30                      $18.00
_____July 1 through September 30               $12.00
_____September 1 through December 31     $11.00

Family member is defined as a family member living under the same roof.
Members presently on the roster will pay the $20.00 upon rejoining even if it is later in the year.

Checks should be made to:
Hill Country Amateur Radio Club
P.O. Box 294802
Kerrville, TX  78029
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