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PEACE RIVER REPEATER ASSOCIATION

(Membership Application)

DATE________________ CALL_________________

CLASS________________ DOB______________

NAME____________________________________

ADDRESS_________________________________

CITY___________________STATE_______ZIP________________

PHONE_____________________E-MAIL ADDRESS_______________________

PACKET ADDRESS _________________________________________________

Preferred method of delivery for PRRA's Newsletter or other Club activities (Circle one):

Email, PRRA Website, PRRA meeting, Postal, KF4HFR packet BBS, Telephone if able.

Preferred method in delivery of important documents pertaining to Club Business (circle One): Email, PRRA Website, PRRA meeting, Postal, KF4HFR packet BBS, Telephone if able.

AREA OF AMATEUR INTEREST (circle all that apply): HF voice, HF CW, VHF/UHF voice, VHF/UHF packet, PSK-31, RTTY, CW, SCTV, ATV, Communication Events, Races/ARES, NTS.

Peace River Repeater Asso.
ATTN: Jack Keim 
PO Box 510943
Punta Gorda, Fl. 33950

Please send comments, suggestions, updates or criticisms to:
Bob N4WFH