Full membership is open to licensed amateurs. Associate membership is open to those actively engaged in a class leading to an Amateur Radio license and all other interested persons. Full membership includes all club privileges as well as rights to hold a club office and to vote for club officers. Associate membership includes all club privileges except for the right to hold office and vote for club officers. Applications for membership shall be submitted at regular meetings.

Name: ____________________________________ Call: __________ License Class: ___________
Address: ________________________________________________ Phone: (____) ____________
E-Mail: _____________________________________ Birthday: _____________________________
Interests: ________________________________________________________________________
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Membership:    ARRL      ARES      RACES      MARS
Committee Interests:    Technical      Education      Field Day      DX
                                        Contesting      Public Service      Publicity      Hospitality
Comments: ________________________________________________________________________________
________________________________________________________________________________

I hereby agree to abide by the Constitution and By-Laws of and all the rules and regulations enacted by the Rip Van Winkle Amateur Radio Society.

Signature: __________________________________________________ Date: ____/____/____