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New Member / Information Update Form
Click here to download this form.
Fill it out, and e-mail it to Dave K9DQ.

Name: ______________________ Callsign: ___________________________

Telephone Number: ____________________

ARRL Member? Yes or No

Street Address: _________________________________________________

City, State and Zip Code: ___________________________________________

QTH Grid Square: ___________ Other Grid Squares You Activate: ____________

What Bands do you operate? Please note the amount of power you have for each band.

_________ 6m _________ 2m _________ 1.25m_________ 70cm _________ 33cm _________ 23cm_________ 13cm _________ 9cm _________ 5cm_________ 3cm _________ 1.2cm _________ 6mm

Anything above 75ghz: __________________________________

Are you on the Internet?_________________

What is your e-mail address? ______________________________________

Is it okay to send club-related material to this address? ____________________

Is it okay to publish your e-mail address in a club newsletter? _______________

Is it okay to publish your e-mail address on the club web page? _______________

What is your web page URL? ________________________________________

Would you like a link from the Club Web Page to yours? ____________________

Are you subscribed to the Club Reflector (Mailing List)? ____________________

Would you like to receive a newsletter in the postal mail, or would you prefer to use e-mail and the web to be kept abreast of club happenings? _______________

What contests do you regularly participate in?

______ January VHF Sweepstakes______ ARRL International DX Contest, CW______ ARRL International DX Contest, Phone______ 50 Mhz Sprint______ 144 Mhz Sprint______ 222 Mhz Sprint______ 432 Mhz Sprint______  Microwave Sprints ( Enter "S" for Spring or "F" for Fall )______ Wisconsin QSO Party______ June VHF QSO Party______ ARRL UHF Contest______ ARRL 10 Ghz and Up Cumulative Contest______ September VHF QSO Party______ ARRL International EME Competition______ November Sweepstakes, CW______ November Sweepstakes, Phone______ ARRL 160m Contest______ ARRL 10m Contest

Other Contests: _________________________________________________

What classification do you typically operate as in the above contests? (ie: Rover, Single Op, QRP/Portable, etc.):

What areas of Amateur Radio are you currently involved, or interested in? (ie, Contesting, Home Brewing, Transmitter Hunting, Weak Signal involving the higher frequencies, EME, etc.)

Please return this survey to K9DQ. You can send it as an e-mail attachment

.last update: Aug 5, 2007

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