Membership Application

New Bern Amateur Radio Club
Please fill out this application so that we can establish Club membership records.
Birthday is optional.

Current Call Sign ________________________________________________________________________________________________________________

Date _____________________________________________________________________________________________________________________________

Previous Call Sign (if applicable)________________________________________________________________________________________________

Name_____________________________________________________________________________________________________________________________

Birthday ___________________________________________________________________________________________________________________________________

Spouse___________________________________________________________________________________________________________________________

Address__________________________________________________________________________________________________________________________

City_______________________________________________________________________________________________________________________________

State________________ Zip______________

Telephone (_____)___________________  Cell (_____) ______________________

Email Address__________________________________________________________________________________________________________________________

License Class and date Earned :

Technician ___________________________________________________________________________________________________________________________________

General  _________________________________________________________________________________________________________________________

Advanced  _______________________________________________________________________________________________________________________

Extra ____________________________________________________________________________________________________________________________

Are you a member of any of these organizations?/Plan to join?

A.R.E.S. ____________  ARRL ___________________

M.A.R.S. ____________  VE _____________________

Would you be willing to serve as a Club officer in the future? ___________________________________________________________________________________________________________________________________

What type of Club activities would you be willing to help with?

___________________________________________________________________________________________________________________________________

Please list what parts of Amateur Radio is of interest to you.

___________________________________________________________________________________________________________________________________

___________________________________________________________________________________________________________________________________

When completed mail to the club or bring to a meeting with a check for $20 (annual dues).
Danny Garris
NBARC President
c/o: GARRIS TV REPAIR
3104 Neuse Blvd.
New Bern, NC 28560
Ph: (252) 638-4477 shop
Ph: (252) 670-9955 Cell

In-Person FCC Amateur Radio License Exam This Weekend in New Bern!

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