SRCC - Surrey Radio Contact Club
Membership Application Form
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Surrey Radio Contact Club
(Affiliated to Radio Society of Great Britain)
Membership Secretary:
Ray Howells G4FFY
9 Aultone Way
SUTTON
Surrey SM1 3LD

MEMBERSHIP APPLICATION
Hon Secretary:
Ray Howells G4FFY
9 Aultone Way
SUTTON
Surrey SM1 3LD

SUBSCRIPTION: £8.00pa
£12.50 Family
To the Membership Secretary

   I wish to become a member of the SRCC and I submit my application for consideration by the Committee.  I agree to abide by and observe the Rules of the SRCC if elected.

   I also agree to my name, address, callsign and telephone number being entered on the SRCC Computer for the purposes of producing Membership Lists and Newsletter envelope address labels.
First Name: Callsign/RS:
Surname:
House Name or Number Member of RSGB:
Street Name: Age if under 21:
Town: Telephone Number: Area Code

Number
County:
Postcode:
Email:


Amateur Radio Interests:


Date of Application:   Signature:
Supporting Member Name:   Signature:

If you have completed all sections of this form correctly hit the 'submit' button below or if you have made a mistake hit the 'reset' button. Only press 'submit' button once.

You will hear from a SRCC member regarding your application as soon as it has been processed.
After pressing the 'submit' button you can move to another area of this site.
Thank you for taking a moment to complete this form.

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This Section For Club Use Only:


Sub Paid:   Receipt No:
Accepted (Chairman):   Date:
Membership Card:   Rules ( ):

Designed and Constructed by G7UKH.
Copyright ©® 1999 G7UKH & SRCC. All rights reserved.
Revised: 28th Oct 2000 by G4FFY.