PALM BAY AMATEUR RADIO CLUB INCORPORATED
(PBARC)
Application for membership. You can also join and pay at:
Join Palm Bay Amateur Radio Club (cheddarup.com)
Formed for the general advancement of Amateur Radio in the greater Palm Bay area.
You need not be a Palm Bay resident or even have an Amateur Radio License to join. Just an
interest.
Dues: $20 per year, January through December. If paid in December, membership is for the next
year.
Call:
License Class: Expiration Date:
First Name:
Last Name:
Street Address:
City:
State:
ZIP:
Home Phone:
Work Phone:
Cell Phone:
Email:
Circle/select affiliations: ARRL ARES
SKYWARN
OTHER
Emergency Contact : Phone:
Do you have emergency power sources
( Batteries, Generator) where you can operate for
24 hours?
YES NO
Return by mail to: PBARC
c/o Ed Johnson W2PH
1805 OAK CT NW
PALM BAY, FL 32907
Return via email to: pbarc@pbarc.org
Office use: Received by:
Date:
