SRRCSouthwest Remote Radio Club
Tri-State Amateur Radio
Loomis Remote Association
Palm Springs Amateur Radio

If you know a system user and you would like to become a member, fill this form out completely.  It will be submitted to SRRC who will forward it to the member for their recommendation.

Candidate's Name:
FCC License Info:
 Call Sign: Class: 

Year First Licensed: 
Residence Address (No P.O.’s):
City:
State:
Zip Code:
 -
Home Phone:
Work Phone:
Fax:
E-Mail Address: 
 @
E-Mail Address(member):
 @
Has candidate been listening to the system?
List of other radio club members the candidate knows (call sign(s) .
What other 440 systems or ham clubs is the candidate a member of ?
Why does candidate have a desire to become a member?
 Please fill in all blanks. We are looking for individuals that will be committed to a long term membership obligation.
 
Non-members name:
Call:
Send Form to SRRC
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