Online Application to JoinKCRC Online Application If you took a Test at the last VE Session Please Contact us with the Contact form for a Discount CodeTodays Date *Your Full Name *Name you would like to be Called by, ( No Nicknames Please ) Your Birthday Call Sign Class License Not Licensed yetTechnicianGeneralAdvancedExtraFirst Licensed in Mailing Address *Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryPhone (Home) Phone (Business) Phone (Cell Phone) Email *Select How did you hear about Kings County Radio Club? Club mailerVE Session handoutClub websiteI heard about it on the radioOtherHow did you hear about us other If you picked other please fill in how you heard of usThe Repeater you are most often on Check mark on the modes you are interested in and if you use it Mobile and/or BaseCheck mark any modes you use for 160 Meters CWDigitalSSBBaseMobileCheck mark any modes you use for 75/80 Meters CWDigitalSSBBaseMobileCheck mark any modes you use for 40 Meters CWDigitalSSBBaseMobileCheck mark any modes you use for 30 Meters CWDigitalBaseMobileCheck mark any modes you use for 20 Meters CWDigitalSSBBaseMobileCheck mark any modes you use for 17 Meters CWDigitalSSBBaseMobileCheck mark any modes you use for 15 Meters CWDigitalSSBBaseMobileCheck mark any modes you use for 12 Meters CWDigitalSSBBaseMobileCheck mark any modes you use for 10 Meters CWDigitalSSBBaseMobileCheck mark any modes you use for 6 Meters CWDigitalSSBBaseMobileCheck mark any modes you use for 2 Meters CWDigitalSSBFMBaseMobileCheck mark any modes you use for 220 MHz CWDigitalSSBFMBaseMobileCheck mark any modes you use for 440 MHz CWDigitalSSBFMBaseMobileMicrowave CWDigitalFMBaseMobileCheck mark the following what you are interested in HomebrewTeachingARRL MemberMobile OperationRACES, ARESAntenna BuildingHomebrew/QRPClassic RadiosDigital ModesField DayWhat are some of your interests in Amateur Radio that you are interested to further explore? Are you a member of A.R.E.S, R.A.C.E.S., M.A.R.S., S.A.T.E.R.N., SKYWARN or N.T.S.? YesNoIf so, which ones? A.R.E.S.R.A.C.E.S.M.A.R.S.S.A.T.E.R.N.SKYWARNN.T.S.Would you like to learn more about any of the above public services? If so, which service(s)? Are you presently a Volunteer Examiner (V.E.)? YesNoIf you hold a General License class or above would you like to learn about becoming a V.E.? YesNoWould you be interested in assisting with the Club’s Technician Radio Classes (theory, government regulations, and/or demonstrations)? YesNoWould you be interested in being an Elmer for a new Ham, or Club member? YesNoAre you presently a member of the American Radio Relay League (ARRL)? YesNoIf not, would you be interested in learning more about the ARRL? (You may join or renew through the Club.)YesNoWhich Membership Plan will you Join. *Active Member - Licensed Amateur $30Family Member (of paid Active Member) $12.50Senior Citizen Member - Over 65 $25.00Associate Member - Unlicensed $23.75Student Member - Under 18/Full Time Student $17.50Membership At A Distance (long distance membership for those wishing to support the Club) $11.00VE Coupon Membership $15.00 FieldsetInstructions Please Enter the 2 digits to be able to click Submit it will then take you to the Paypal Website to pay for your Dues. Thank you for becoming a member of Kings County Radio Club VerificationPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank:
