{"id":800,"date":"2021-08-05T10:17:04","date_gmt":"2021-08-05T14:17:04","guid":{"rendered":"https:\/\/bcra.club\/bcrawprel\/?page_id=800"},"modified":"2025-01-03T14:00:44","modified_gmt":"2025-01-03T19:00:44","slug":"bcra-membership-form","status":"publish","type":"page","link":"https:\/\/bcra.club\/bcrawprel\/bcra-membership-form\/","title":{"rendered":"BCRA Membership Form"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\">Membership Application<\/h2>\n\n\n\n<p><strong>Mailing Address<\/strong>:<\/p>\n\n\n\n<p>Bristol County Repeater Association (BCRA)<\/p>\n\n\n\n<p>C\/O Tom Medeiros<\/p>\n\n\n\n<p>88 Alsada Road, Swansea, MA 02777-2821<\/p>\n\n\n\n<p><strong>Make checks payable to:<\/strong>  Bristol County Repeater Association, Inc. <\/p>\n\n\n\n<a href=\"https:\/\/bcra.club\/bcrawprel\/wp-content\/uploads\/2025\/01\/BCRAMemberApp.pdf\">BCRA PDF Application<\/a>\n\n\n\n<p><\/p>\n\n\n\n<a href=\"https:\/\/www.arrl.org\/files\/file\/Membership\/ARRLAffiliatedClubMembershipApplication.pdf\">ARRL Application<\/a>\n\n\n\n<p><\/p>\n\n\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f113-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"113\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/bcrawprel\/wp-json\/wp\/v2\/pages\/800#wpcf7-f113-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"113\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f113-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<p>Membership Type (required) <span class=\"wpcf7-form-control-wrap\" data-name=\"app-type\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"app-type\" value=\"Individual $20yr\" \/><span class=\"wpcf7-list-item-label\">Individual $20yr<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"app-type\" value=\"Family $25yr\" \/><span class=\"wpcf7-list-item-label\">Family $25yr<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"app-type\" value=\"Student $10yr\" \/><span class=\"wpcf7-list-item-label\">Student $10yr<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"app-type\" value=\"Renewal\" \/><span class=\"wpcf7-list-item-label\">Renewal<\/span><\/span><\/span><\/span>\n<\/p>\n<p>Call Sign <span class=\"wpcf7-form-control-wrap\" data-name=\"call-sign\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"call-sign\" \/><\/span>\n<\/p>\n<p>License Expiration <span class=\"wpcf7-form-control-wrap\" data-name=\"lic-exp\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"lic-exp\" \/><\/span>\n<\/p>\n<p>Select Class <span class=\"wpcf7-form-control-wrap\" data-name=\"class\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"class\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Technician\">Technician<\/option><option value=\"General\">General<\/option><option value=\"Extra\">Extra<\/option><option value=\"Novice\">Novice<\/option><option value=\"Advanced\">Advanced<\/option><\/select><\/span>\n<\/p>\n<p>Name (required) <span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span>\n<\/p>\n<p>Address (required) <span class=\"wpcf7-form-control-wrap\" data-name=\"address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"address\" \/><\/span>\n<\/p>\n<p>Town (required) <span class=\"wpcf7-form-control-wrap\" data-name=\"town\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"town\" \/><\/span>\n<\/p>\n<p>State (required) <span class=\"wpcf7-form-control-wrap\" data-name=\"state\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"state\" \/><\/span>\n<\/p>\n<p>Zip (required) <span class=\"wpcf7-form-control-wrap\" data-name=\"zip\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"zip\" \/><\/span>\n<\/p>\n<p>Email (required) <span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span>\n<\/p>\n<p>Phone Number (required) <span class=\"wpcf7-form-control-wrap\" data-name=\"phone-num\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"phone-num\" \/><\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"list-num\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"list-num[]\" value=\"Check if you want your telephone number listed on the club roster\" \/><span class=\"wpcf7-list-item-label\">Check if you want your telephone number listed on the club roster<\/span><\/span><\/span><\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"arrl-mem\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"arrl-mem[]\" value=\"ARRL Member\" \/><span class=\"wpcf7-list-item-label\">ARRL Member<\/span><\/span><\/span><\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"arrl-info\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"arrl-info[]\" value=\"Would you like ARRL Information\" \/><span class=\"wpcf7-list-item-label\">Would you like ARRL Information<\/span><\/span><\/span><\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"arrl-app\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"arrl-app[]\" value=\"Would you like ARRL Application\" \/><span class=\"wpcf7-list-item-label\">Would you like ARRL Application<\/span><\/span><\/span><\/span>\n<\/p>\n<p><label> Please include any other information or questions:<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"message\"><\/textarea><\/span> <\/label>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap kc_captcha\" data-name=\"kc_captcha\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"captcha-image\" ><span class=\"cf7ic_instructions\">Please prove you are human by selecting the<span> star<\/span>.<\/span><label><input aria-label=\"1\" type=\"radio\" name=\"kc_captcha\" value=\"kc_human\" \/><svg aria-hidden=\"true\" role=\"img\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 576 512\"><path fill=\"currentColor\" d=\"M259 18l-65 132-146 22c-26 3-37 36-18 54l106 103-25 146c-5 26 23 46 46 33l131-68 131 68c23 13 51-7 46-33l-25-146 106-103c19-18 8-51-18-54l-146-22-65-132a32 32 0 00-58 0z\"\/><\/svg><\/label><label><input aria-label=\"2\" type=\"radio\" name=\"kc_captcha\" value=\"bot\" \/><svg aria-hidden=\"true\" role=\"img\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 512 512\"><path fill=\"currentColor\" d=\"M350 99c-54 0-98-35-166-35-25 0-47 4-68 12a56 56 0 004-24C118 24 95 1 66 0a56 56 0 00-34 102v386c0 13 11 24 24 24h16c13 0 24-11 24-24v-94c28-12 64-23 114-23 54 0 98 35 166 35 48 0 86-16 122-41 9-6 14-15 14-26V96c0-23-24-39-45-29-35 16-77 32-117 32z\"\/><\/svg><\/label><label><input aria-label=\"3\" type=\"radio\" name=\"kc_captcha\" value=\"bot\" \/><svg aria-hidden=\"true\" role=\"img\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 576 512\"><path fill=\"currentColor\" d=\"M472 200H360L256 6a12 12 0 00-10-6h-58c-8 0-14 7-12 15l34 185H100l-35-58a12 12 0 00-10-6H12c-8 0-13 7-12 14l21 106L0 362c-1 7 4 14 12 14h43c4 0 8-2 10-6l35-58h110l-34 185c-2 8 4 15 12 15h58a12 12 0 0010-6l104-194h112c57 0 104-25 104-56s-47-56-104-56z\"\/><\/svg><\/label>\r\n    <\/span>\r\n    <span style=\"display:none\">\r\n        <input type=\"text\" name=\"kc_honeypot\">\r\n    <\/span><\/span><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Membership Application Mailing Address: Bristol County Repeater Association (BCRA) C\/O Tom Medeiros 88 Alsada Road, Swansea, MA 02777-2821 Make checks&#8230;<\/p>\n","protected":false},"author":1,"featured_media":6,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"ngg_post_thumbnail":0,"footnotes":""},"class_list":["post-800","page","type-page","status-publish","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"https:\/\/bcra.club\/bcrawprel\/wp-json\/wp\/v2\/pages\/800","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bcra.club\/bcrawprel\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/bcra.club\/bcrawprel\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/bcra.club\/bcrawprel\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/bcra.club\/bcrawprel\/wp-json\/wp\/v2\/comments?post=800"}],"version-history":[{"count":7,"href":"https:\/\/bcra.club\/bcrawprel\/wp-json\/wp\/v2\/pages\/800\/revisions"}],"predecessor-version":[{"id":2799,"href":"https:\/\/bcra.club\/bcrawprel\/wp-json\/wp\/v2\/pages\/800\/revisions\/2799"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bcra.club\/bcrawprel\/wp-json\/wp\/v2\/media\/6"}],"wp:attachment":[{"href":"https:\/\/bcra.club\/bcrawprel\/wp-json\/wp\/v2\/media?parent=800"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}