Membership Application Form

Declaration
I wish to apply for membership of the Shirehampton Amateur Radio Club.
I agree to abide by the rules and constitution of the club and to observe the spirit of amateur radio.

Name

Email Address

Callsign (if held)

Address

Post Code

Are you under 16? —Please choose an option—NoYes

Name of Parent (if under 16)

Contact Phone Number (if under 16)

Payment Preference —Please choose an option—AnnualSmall Annual Fee + Sub

Any questions?

Additional Information
We publish a list of our membership on this website. This would include name/callsign and a photograph if you upload/agree for it to be published. Your email address will be used for registration purposes, but this is not published.

Do you give your consent for the Club to publish your data on our website?
I consent to the conditions.