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GMCC Membership Application Form

(see below for dues info.)

 

. 
 
(A) Your Name:  
(B) Email:
(C) Callsign:
(D) License Class: choose:  Novice  Tech  Tech Plus  General  Advanced  Extra
(E) Street Address:
(F) City:
(G) State:          Zip:
Optional:
(H) Home Phone:
(I) Year First Licensed:
(J)Are you a member of ARRL ?  
(K)If ARRL Member, Lifetime (Y/N)  
(L)Member of other clubs ?  Names Please .  
(M) Other/Previous Callsigns:

(N) Most recent contest experience:
 
 
 
 
 

(O) Operating Awards Such As DXCC, WAC, WAS, WAZ, if any:
 
 
 
 
 

(P) Describe Your Station:
 
 

(Q) Other amateur interests:
 
 

(R) Other non-ham interests:
 
 

I will make a reasonable effort to participate in ARRL and CQ contests and submit the logs in accordance with the contest rules. I will support and encourage other contesters and GMCCers in contesting.
(S) SIGNED: 

 

 

Print out and complete the form above then send a check made out to "GMCC" for $15 (dues for one year) to:

Ashton Lee  KQ0C
473 Diamond A Ranch Rd
Carbondale CO 81623

Family membership is $16
Student (full-time) membership is $1 (please include name of the school you attend)

 

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