BCRA Membership Form

Membership Type (required) Individual $20yrFamily $25yrStudent $10yrRenewal

Call Sign

License Expiration

Select Class —Please choose an option—TechnicianGeneralExtraNoviceAdvanced

Name (required)

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Email (required)

Phone Number (required)

Check if you want your telephone number listed on the club roster

ARRL Member

Would you like ARRL Information

Would you like ARRL Application

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