***********************APPLICATION FOR MEMBERSHIP**********************

HIGHLAND LAKES AMATEUR RADIO CLUB, INC.
P.O. BOX 856
Kingsland, Texas 78639

I hereby apply for membership in the Highland Lakes Amateur Radio Club, Inc. I understand that this application will be presented to the membership for a vote at the first regular meeting following receipt of this application accompanied by appropriate dues (all applicants) and a copy of applicant's Amateur Radio license (applicants for full membership) by the Clubs Secretary. If for any reason membership is rejected, all dues accompanying the application will be returned to the applicant. There are three types of Memberships:

* Full (voting): The applicant must possess a valid amateur radio license.  (Copy with application)

* Associate (non voting): For an unlicensed applicant aspiring to become an amateur radio operator.

* Family (voting): For multiple licensed amateur radio operators in the same household (each considered a full member).

Dues: A full or associate membership is $24.00 per calendar year (January – December), Prorated at $ 2.00 per Month for those joining in March or later. Family membership dues is the cost of one Full membership plus $ 2.00 ($26.00 for the whole year). Please furnish a separate application for each Amateur Radio Operator involved in the Family (single household) membership, with the total amount submitted shown only on the first application (write “family” for the amount submitted on the remaining application(s)). Make checks payable to: Highland Lakes Amateur Radio Club Inc.

Please Print Information:

Name: ________________________________________ Telephone: (____)_______________

Spouse Name: _____________________________Spouse E-Mail______________________

Address: ___________________________City________________Zip_________ County___________

E-mail: ______________________DOB (M-D)____________ Spouse DOB (M-D)___________

Call Sign____________License Class_____________Exp_______ARRL Member Y / N Exp________

Submitted Amount $_____. 00      Type Membership  - Full / Associate /  Family  (circle one)

I do / do not (circle one) authorize the above information to be included in The Highland Lakes Amateur Radio Club, Inc. Membership Directory.  

I do / do not (circle one) authorize to be added to the HLARC club reflector for club emails. (if requested, you will receive an email list invitation, accept it to join)

Signature:______________________________________Date:________________

Date Approved:_________________

Last updated, October, 2016