OMARC, Inc.

Membership/Renewal Application

(Please print clearly and use an additional form for each family member as applicable)

Call Sign: __________________________
Name: _____________________________________________
Street: _____________________________________________
City/State: ___________________________ ZIP __________

Home Phone:_________-_________-__________

E-mail (Required):__________________@__________________
ARRL member: (Yes/No) ARRL Life member: (Yes/No)

Volunteer Examiner (VE) ARRL/W5YI/Other: (Yes/No)

ARES: (Ocean/Monmouth) (Yes/No) NJ State RACES: (Yes/No)

MARS Member: (Yes/No) MARS Callsign: _______________

OMARC Dues Total (See schedule below) $__________
Lightening Fund Contribution $__________
TOTAL AMOUNT ENCLOSED $__________
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Please complete the above information and mail with your check to:
OMARC, Inc.
P.O. Box 267
Oakhurst, NJ 07755

-------------------------------------------------- DUES SCHEDULE ---------------------------------------------
Dues are collected on a calendar year basis and are not pro rated monthly. If dues are not received by February 1^st yearly membership is considered expired and will need to be reinstated.

• New members & reinstatements are $40.00 (includes name badge for new member). Dues paid for new members and reinstatements after September 1^st shall cover the following calendar year as well.
• Full Member Renewals $30.00 (Early Renewals are $25.00 per year (3 years maximum) if paid before Jan 1^st) .
• Full time students under the age of nineteen not living at home are $10.00 per person.
• Family memberships living in same household are $10.00 per additional family member.
• Out-of-State memberships are $10.00 per person.

_{From revised 10 January 2008}