Application for TARC Membership

Name ____________________________________________ Call ______________

Address ____________________________________________________________

City ______________________________ State ___________ Zip ______________

Home Phone _______________________ Work Phone _______________________

Date First Licensed ________________ Current License Class __________________

Current License Expiration Date __________________________________________

Has your FCC license ever been revoked? ______ ARRL Member? ______

e-mail address: _______________________________________________

Other capabilities: Emergency power? ______ Portable tower or mast? ______

Type of Membership:
____ Regular $20.00
____ Family $30.00
____ Printed Newsletter via Mail $6.00 (otherwise vie Email)

I, the undersigned, do hereby agree to abide by the Tulsa Amateur Radio Club, Inc.,
Constitution and Bylaws, the Federal Communications Commission rules and regulations, and
support the Tulsa Amateur Radio Club in the advancement of amateur radio and public services.

Signature of Applicant __________________________________________________

Date ___________________________

Print and complete application, and mail it with a check to:

Tulsa Amateur Radio Club
Membership Committee
P.O. Box 4283
Tulsa, OK 74159