Registration Page

Northern Colorado Amateur Radio Club
Application Form

____ I want to join the NCARC. My payment is enclosed.
____ I want to renew my membership. My payment is enclosed.

Annual Dues:
Family Membership: $25.00
Full Time Students: $5.00

All memberships expire at the end of the Calendar Year

Please fill in the following information.  If you are renewing please fill in your Name and call unless other information has changed. Any items left blank will be assumed to be correct in the NCARC database.

Name: __________________________________
Callsign: ______________________________
Street: ________________________________
City: __________________________________
State: _________________________________
Zip: ___________________________________
Telephone: _____________________________
License Class: _________________________
E-mail Address: ________________________

Join/Renew for year: _______

Please Select the following:

Student? YES NO  School: _________________


Please mail this form and payment (payable to NCARC)  to:

P.O. Box 272956
Fort Collins, CO 80527-2956