Application

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Metro DX Club Officers

President: Robert Adamitis K9MDO

Vice-President: John Holmes W9ILY

Secretary/Treasurer: Jack Nienhaus W9NJB

Webmaster: John Holmes W9ILY

                       

METRO DX CLUB

CLUB CALL – W9TY  

5045 Oak Center Drive Oak Lawn, IL 60453-3961

www.metrodxclub.com

(PLEASE PRINT)

Name:_____________________________________________ Call: ____________________

Address:______________________________________ License class:___________________

City:____________________________________ State: ______ Zip: ____________________

Phone:_____________________ E-Mail: _________________________________________

ARRL Member?    Yes______    No______  Use LoTW? Yes _____ No ______

Number of Countries – Worked___________ Confirmed_____________

Amateur awards received: ______________________________________________________

Other Amateur Radio clubs you belong to:

__________________________________________________________________________

Other information:……………………………………………………………………………

Occupation: ________________________________________________________________

Your Main Interests for club activities are:

Club sponsored DXpeditions: _________ Field Day: _____________

Helping maintain club web site ____________ Contest operating as a club: _________________

Other: _____________________________________________________________________

What other hobbies do you have?: ________________________________________________

_________________________________________________________________________

Date: ________________________

Please print this application, complete, and mail to our address below. You will be contacted with information regarding your requested membership and annual dues:

Metro DX Club

5045 Oak Center Drive

Oak Lawn, IL 60453

U.S.A.

Metro DX Club

5045 Oak Center Drive

Oak Lawn, IL 60453

U.S.A.

To contact us, please email: membership@metrodxclub.com