GCARC Membership Application

Gloucester County Amateur Radio Club

On-Line New Membership Application
Today's Date*

MonthDayYear
Date
Full Name

First NameMiddle NameLast Name
Mailing Address:

Street Address

Street Address Line 2

CityState

Zip Code
Membership Badge? : Contact Chris Prioli, AD2CS at : chris@ad2cs.com if you want a badge.
Birth Date :

MonthDayYear
Date
Physical Address (if different):

Street Address

Street Address Line 2

CityState

Zip Code
Cell Phone Number:

Area CodePhone Number
Home Phone Number:

Area CodePhone Number
E-Mail Address
Grid Square
Optional

New Membership Classifications and Fees
All applications are subject to final approval by the Board of Directors.

Dues and memberships run from January 1^st to December 31^st of each year.

Renewal Dues Must be Paid by March 31^st of Each Year.
- Full Membership (A Full Member Must Hold a Valid Amateur Radio License)
- Family Membership (Licensed and Lives in the Same Household as a Full Member)
- Associate Membership (Unlicensed Person Who is Interested in the Objectives of the Club)
- Student Membership (Licensed, Under 25, and Enrolled in a Full-Time Educational Program)
- Life Membership (Available After Becoming a Full Member) : See the Membership Chair for details
Individuals who join the Club in October, November, or December, the Membership Fee will cover the balance of the current year PLUS the entire next year.
New Membership Class Applying For :

Full Membership : $30.00Associate Membership : $25.00Family Membership : $15.00Student Membership : FREE
Applicant's Signature*
Thank you for submitting your application.

Your application will be processed by the Membership Committee and submitted to the Board of Directors for approval.

Clicking the "Submit Application" button will transfer you to our "Pay Dues Here" page.

Gloucester County Amateur Radio Club