2008
East Coast Long Wire Association Membership Application
Today’s
Date: ________________________________
Name:
______________________________________
Street
Address: _______________________________
City,
State Zip Code: ___________________________
Call
Sign: ______________ License Class: _____________________
Phone:
(____)___________ Email: ___________________________
Membership:
Regular________ Associate________ Renewal________
Both
are yearly and the dues are $20.00 a year
If
accepted for membership in the ECLWA, I agree to actively promote, support and
participate in meetings, classes, programs, contests and other such activities
as the club may sponsor or engage in IN SO FAR AS I
AM ABLE as a matter of personal responsibility to Club membership. I understand
that my membership may be suspended and / or revoked for reasons of personal
misconduct, violation of FCC regulations or for acts which are detrimental to
the amateur radio service or the ECLWA, or for serious violations of the Club
Charter and / or By Laws or for non-payment of dues.
Signature
of Applicant: _____________________________________
Signature
of Parent or Guardian: _____________________________
If 17 years
old or younger
Paid by Cash or Check: _____________________________________
Make Checks Payable to ECLWA, Inc.
Date
Membership Voted: ____________________________________
Mail membership
form and check to:
East Coast Long Wire Association
1754 Route 47