Application for Membership - Metro DX Club

• Please provide your contact information:

  Name
  Phone
  Occupation
  Callsign
  E-mail

• Please let us know your age:

  Date of Birth

• License Class:

  Technician General Advanced Extra
  

• Are you an ARRL Member?

  YES NO
  

• Number of Countries Worked:

• Number of Countries Confirmed:
  

• Do you use LoTW?:

  Yes No
  

• Please let us know about the Amateur Awards have you received.

  
  

• Are you a member of other Amateur Clubs? Which ones?

  
  

• Which activities interest you?:

  Club Sponsored DXpeditions
  Field Day
  Helping maintain club web site
  Contest operating as a club
  

• Other club activities that would interest you are:

  
  

• What are your other hobbies?

  
  

  Date Submitted:

  Thank you for your application! You will be contacted with information regarding your requested membership and $10.00 annual dues.