Faulkner County Amateur Radio Club, Inc.

Membership Application 2008 (Memberships are for the calendar year)

P.O. Box 324

Conway, AR 72033

www.w5auu.org

Individual membership $10.00 Family membership $15.00

Name: _____________________________ Call Sign: _____________

Address: _____________________________________________________

City: ______________________________ Zip: _____________________

Phone: _______________________________________________________

E-Mail: ______________________________________________________

ARRL Member Yes [ ] No [ ] License Class: ____________________

Emergency Contact Name: ____________________ Phone:_____________

If this is a family membership, please list all other ham family members living at the address above.

Name: _____________________________ Call Sign: ________________

E-Mail: ______________________________________________________

ARRL Member Yes [ ] No [ ]

Name: _____________________________ Call Sign: ________________

E-Mail: ______________________________________________________

ARRL Member Yes [ ] No [ ]

Name: _____________________________ Call Sign: ________________

E-Mail: ______________________________________________________

ARRL Member Yes [ ] No [ ]

Name: _____________________________ Call Sign: ________________

E-Mail: ______________________________________________________

ARRL Member Yes [ ] No [ ]

The FCARC meets at Smitty's BBQ on Harkrider Street in Conway. Meetings are the 2^nd Tuesdays of the month at 5:30 pm. Lunch is every Friday at 11:00 am.