Montreal Amateur Radio Club

MEMBERSHIP APPLICATION FORM 2019 / 2020
(Membership year is September 1 to August 31)

Last Name: First Name:

Callsign:

Address:

City: Prov:

Country: Postal code:

Home Phone:

Work phone: ext.:

E-mail:

Postage and printing of the MarcOgram represents a substantial expense for the club.
If you would prefer your Marcogram to be sent by Canada Post there is a $5.00 surcharge to cover the increased postage costs.

Single membership ($30.00)

Family membership ($35.00)

MarcOgram sent by Canada Post ($5.00)

Call or name of family members:

If you are a first time member,
who introduced you to MARC:

Are you a member of Radio Amateurs of/du Canada (RAC)? YES NO

Date: 2019-12-15