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CUMBERLAND PLATEAU AMATEUR RADIO CLUB (CPARC)    www.cparc.net

NAME:___________________________________________________ DATE:_____________

CALL SIGN:_____________________ LICENSE CLASS:_____________________________

STREET ADDRESS:___________________________________________________________

CITY:______________________________ STATE:_________ ZIP:_____________________

TELEPHONE:______________________

E-MAIL:___________________________________

CLUB ACTIVITY INTERESTS: FIELD DAY_____ REPEATER NETS _____ HF NETS _____

HAMFEST _____ VE TESTING _____ TRAINING CLASSES _____ ARES ______________

QRP _____ CW _____ HOME BREW _____ CONTESTS _____ OTHER ______________

Dues are $24.00/year. Membership dues are due and payable yearly on January 1st.
New members who join CPARC after March 31st, will pay a prorated amount of $2.00 per
month for the remaining months of the year. Alternately, new members joining in October,
November or December may choose to pay the full amount of the yearly dues for the
following year. In this case, membership would begin upon payment of this yearly amount.
Send this application and your check to:
Cumberland Plateau Amateur Radio Club, P.O. Box 1473, Crossville TN 38557