W7BU/SEARC — Membership Application & Dues Schedule

Join the Sunset Empire Amateur Radio Club!

Sunset Empire Amateur Radio Club Dues for 2010 are:
$15 Individual yearly dues
-or-
$20 Family yearly dues
(Individual + Spouse or "S.O.", plus any dependent children living at home)

SEARC is a 501(c)(3) Tax Exempt Organization, #94-3023696,
Contributions are Tax-Deductible

Membership in SEARC entitles the member(s) to attend all activities, club functions, and have voting privileges on issues at regular membership meetings held once per month (except December). Dues go towards assisting with purchase, repair, upkeep and maintenance of the local repeaters owned by W7BU and for other club activities. If you live, work, or travel in Clatsop County and use the W7BU repeaters, please consider joining the Sunset Empire Amateur Radio Club and assist in maintaining the system and the equipment that you are already using.

Fill this form out first, then proceed to the PayPal payment page if you choose to pay online,
otherwise print this form out and bring to a meeting or mail it with payment to:
SEARC Membership
PO Box 264
Astoria, OR 97103-0264

Sunset Empire Amateur Radio Club Membership Application Form
NOTE: If you have already submitted the form below once, but need to return to the PayPal page later for whatever reason, please do not submit your application again below (we get multiple copies that way). Instead, go directly to the PayPal payment page, http://www.w7bu.org/paypal.html.

Fields marked with * are required.

Last Name *   First Name *
Call Sign *        Email Address *
I would like an "@w7bu.org" email address of: @w7bu.org to forward to my address.
Home Phone *    Work Phone     Mobile Phone
                               Format: (503) 123-4567                                  Format: (503) 123-4567                                    Format: (503) 123-4567
Membership Type *   New MemberRenewal

If "Family Membership", please list all other licensed Hams in your household, their Call Signs, phone numbers & email address(es) (if different from above) and age (for dependents)

Mailing Address
Street 1 *
Street 2
City  *            State *   Zip Code *   Zip+4

Physical Address (if different from above)
Street 1
Street 2
City             State    Zip Code    Zip+4

If you'd like a picture of yourself, your ham shack, or another ham related photo to accompany your name in our members' list, please attach a GIF (.gif), JPEG (.jpg), PhotoShop (.psd) or Portable Network Graphic (.png) image here - if multiple pictures (for each member of a Family Membership), please enclose them, clearly identified, all in one .zip file [if you are mailing or hand-delivering this application, either physical photo(s) or a CD with the photo(s) on it are acceptable, but cannot be returned]

Comments, questions, short bio of yourself, whatever you would like to add to the above info

Go directly to PayPayPal payment page without submitting application above
(use ONLY if application above has already been submitted previously)

Sunset Empire Amateur Radio Club

When All Else Fails... Amateur Radio Works!

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