COARC Membership Application

C.O.A.R.C.
Central Ontario Amateur Radio Club
Membership Application

To join COARC, please print and complete this page. Then forward to the address shown at the bottom of the page.

Objectives of the Central Ontario Amateur Radio Club

To promote fun and fellowship amongst amateur radio operators, and to inform any interested persons of the hobby’s many venues.

To promote any idea, development or activity that advances amateur radio.

To join COARC, please print and complete this page. Then forward to the address shown at the bottom of this page.

Name:__________________________________________ Call Sign:___________________________
(Surname First)

Home Address: Street:________________________________

Town:________________________________

Postal Code:___________________________

Note: Please give the full mailing address to which your correspondence should be sent.

Phone Number: Home: (_______)___________________________

Work: (_______)___________________________

Email: ____________________________________

Class of License: Basic____ Basic + 5w.p.m.____ Basic + 12w.p.m.____ Advanced____

Interests: (i.e.: VHF, HF, PACKET, A.P.R.S.)

Would you be interested in working as part of the executive (Yes or No):______

This membership application is subject to acceptance by the membership of the club and is subject to review.

Waiver of Liability

In consideration of your signing this application for membership to the Central Ontario Amateur Radio Club (C.O.A.R.C.), its agents, servants, representatives, successors and assignee and other bodies, corporate firms, associations, or person connected with the C.O.A.R.C., of and from all rights, claims, demands or actions whatsoever that I may have for any/all loss, damage or injury sustained by me or my equipment during any and all organized events on behalf of the club.

Please make cheques payable to : C.O.A.R.C. (Fee for 1 year is $20.00)

        C.O.A.R.C.
c/o Don Mathews VE3IXJ & VE3PO
       420 William Graham Drive
       Unit 414
       Aurora, Ontario
       L4G1X4

                        Phone # 416-238-1182 - 905-418-1116

Signature:______________________________ Witness:_______________________________

Date:__________________ Membership Fee Paid:____________________

Note: All memberships are subject to the by-laws of the club.