Catalina Radio Club
Raytheon Missile Systems Company
M/S 842-12
2008 Membership Form
Name:______________________________ Signature:_______________________________
Callsign:_______________ CRC Membership: New: Renewal:___
Payroll Number:___________ Department:___________ Work Phone:______________
Site (AIR/RR/RW):__________ Bldg & Col:______________ M/S:_____________
Home Address:
Home Phone:_____________ Home Email:________________________________________
Pager:__________________ Work Email:________________________________________
Lic. Class: (N/T/T+/G/A/E):____ Expires (Mo/Yr):_________ Years a Ham:______
Upgrade Interest: Yes:___ No:___ N/A:___ Need Help: Yes:___ No:___ N/A:___
ARRL Member: Yes:___ No:___ Since (Yr):_____ ARRL Email:___________@arrl.net
ARRL ACTIVITIES (VE/EC/TS/OO/?):_____________________________________________
Other HAM Activities (ARES, RACES, Clubs):___________________________________
Bands/Modes You Operate:
Fixed:_____
CRC activities (please mark any you are interested in):
___ Field Day ___ Swap Meets ___ Emergency Comm Team
___ Club Repeaters ___ Club Packet Station ___ Property Manager
___ Station Engineer ___ AMSAT Activities ___ ARCA
___ Social Activities ___ T-Hunts ___ Radio Control
___ Training ___ V.E. Testing ___ Web Page
___ DX ___ Community Support (Bike Race, Walkathon, etc.)
Other??:_____________________________________________________________________
What Do You Expect Out Of A Ham Club? _______________________________________
_____________________________________________________________________________
How Can We Be A Better Club? ________________________________________________
_____________________________________________________________________________
Dues are $5.00 per calendar year, prorated by quarter for new members. Please
pay by check, payable to CATALINA RADIO CLUB, and send to: Catalina Radio
Club, Mail Stop TU/842/12 by RMSC internal mail or the external address above.
Official Use Only: Date___________ Member Number______ Paid by______