W2SO NEW MEMBER – ONLINE MEMBERSHIP APPLICATION

First Name *

Last Name *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country

Email Address *

Primary Phone *

Secondary Phone

Callsign *enter your callsign. If you don't have one, enter "N/A"

What Is Your Current License Class? *Choose whichever option that most closely resembles your license class/category

Are You A Current ARRL Member? *YesNo

Are You A Previous LARC Member? *YesNo

Emergency Contact Name

Emergency Contact Phone

Have you read the club bylaws and agree to abide by them? *Yes & I AgreeOur bylaws are posted here: https://w2so.org/index.php/club-bylaws/

YOUR FULL NAME *Enter your full legal name before submitting your application. By submitting a membership application with your name typed above, you agree to adhere to all club bylaws. Members who violate rules set in the bylaws may face sanctions up to and including expulsion from the club.

Payment Notice *I understand that after submitting I will be redirected to the W2SO PayPal page to submit my $25 initial dues