Membership in the CVFMA

Membership in the CVFMA is open to all licensed radio amateurs,
foreign and domestic. Even if you are a member of another club,
we encourage you to join the CVFMA.

=========================================================

Connecticut Valley FM Association
Application for Membership or Renewal

Callsign:______________

Name:_______________________________________

Phone:_______________

E-Mail:________________________________________

Mailing Address:_________________________________

City/Town:__________________ State:____ ZIP:_______

ARRL League member(s)?____ Regular ______Life

Membership through June 30
Number	Kind of Membership	Cost	Amount
	LIFE MEMBERSHIP (One Member, no expiration)	$300	$
	FULL MEMBERSHIP (One Member)	$20	$
	FULL MEMBERSHIP (Senior age 65 or older)	$13.50	$
	FULL TIME STUDENT (Under 18 years and living at home)	$10	$
	Additional Family Members (2010)	$7.00	$

Please accept my contribution to Repeater Maintenance.......................................$_______

TOTAL-$_________

Member Information

Your Birth Date:________________ Anniversary Date:__________________

Favorite Amateur Radio Interests: _________________________________

Spouse’s Name:________________ Spouse’s Birth Date:____________

The Board wants to hear from you. Please add any comments, suggestions,
or concerns at the bottom or on the reverse side of this application.

Send Completed Application and Payment To

Connecticut Valley FM Association

Bruce Van Houten, Treasurer

P.O. Box 35

Windsor, VT 05089

Updated July 6, 2010

< Prev		Next >

Last Updated ( Wednesday, 07 July 2010 10:36 )