Saddleback Repeater Association Inc.                 Membership/Renewal Application

SRA Membership
394 Meaderboro Rd
Farmington, NH 03835


Name (Full)_______________________________________ Call Sign: ____________

Mailing Address:

_________________________________________________________________________________________
Street                                           Town       State                Zip

Home Phone # ________________________   Work Phone #  (Optional)_________________________

License Class:  ( Novice    ( Tech    ( Tech Plus    ( General    ( Advanced    ( Extra

E-MAIL Address: __________________________________________________

Other Licensed Family Members  (Living at same address)

Name: _____________________________________ Call Sign: _________________

Name: _____________________________________ Call Sign: _________________

Name: _____________________________________ Call Sign: _________________

We are always looking for members who would like to participate in Club activities.  
If you are interested, please indicate below in what areas:  
We need help and suggestions!!

* I would be interested in serving on any SRA committee.

* I would be interested in participating in any activities that might come up in the SRA.

* Other: __________________________________________________________

What skills, hobbies, services, etc. of yours might the SRA use to assist the club in its operation?   

_____________________________________________________________________

_____________________________________________________________________

Dues are $20.00/year.  Family dues are $25.00/year. New hams - one year free membership   
Mail application and dues to the address above.


Date: _________________Signature: ______________________________________

W1SRA / 147.000Mhz / Negative Offset / 100.0 PL Tone
Sunday Night Net each Sunday evening at 8:00 PM.
All are welcome!