Membership Application (please type or print)


  Name____________________________________________Callsign_____________________

  Address_____________________________________Email____________________________
  City_________________State________

  Phone (____)_______________ ARRL Member ? ___  License class__________



  Please make checks payable to "Madison County Amateur Radio Club"
  Send to:   Kevin Etchison
                 1605 Longwood Drive
                 Alexandria, IN 46001-2821

  Full membership $20 per year___  Associate Member (newsletter only) $10 per year____
  Family member $2 per year ___  There must be one full member to have a family membership.
  Family member must live in same household as Full Member.


  If you are on the internet, and would like to read the newsletter online instead of 
  requiring a paper  version, please check here ____

  If you can, it would save a lot of work, and a lot of money for the club. 
  The newsletter will always be at this web site:

  www.w9vcf.org/newsletter.html  or just go to  w9vcf.org and click on “Club newsletter”