Suburban Amateur Repeater Association

Amateur Call _______ Class __________ Expiration Date ______________________
Name _______________________________________________ Date ___________
Address _____________________________________________________________
City ____________________ State ____ Zip _________ Occupation _____________
Date of Birth ____________ Home Phone ______________ ARRL Member(Y/N) ___
E-mail address ________________________________________________________
Other members of your household who are HAMS: ____________________________
____________________________________________________________________

Suburban Amateur Repeater Association

c/o Robert Schiff

6628 N. Richmond Street

Chicago, Illinois 60645-4211

I would like to have a Quick-Call for the following phone number: _____________________

I am interested in participating on the following committees:

Interference

Technical

Newspaper

Special events

Special Interests/Qualifications _______________________________________________
_______________________________________________________________________

When accepted for membership in the Suburban Amateur Repeater Association, I hereby agree to fully abide by the Constitution and by-laws of this organization and any additional rules and regulations that are set by the Board of Directors of SARA.