CVARC Membership/Renewal Application

CVARC Membership/Renewal Application

(You may also use this form to submit call sign, email, address, and phone updates)
Today's Date

MonthDayYear
Date
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Call Sign *
License Class

TechnicianGeneralAmateur ExtraOther
Do you want a new or replacement CVARC membership badge?*

YesNo
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
If you are using this form to update your personal information or request a badge, click the "Submit" button now.

If you want to pay for a new or renewal membership by credit card, please complete the rest of this form. Your credit card transaction will go through when you "Submit" the completed form.
CVARC Membership/Renewal

CVARC annual membership dues are payable in May. If you are joining the club during any other month of the year, follow the instructions below for prorated dues to put you on a May renewal schedule.

Renewals: Click Renewals under Membership Status. Select desired Membership Type, dues amount will appear as "Membership Price."

New Members: Click New Members Under Membership Status. Select today's date in the Start Date box. Select desired Membership Type, dues amount will appear as "Prorated Amount."

The appropriate dues amount will appear in the credit card "Payment Amount" window.

If you are a new member and you do not want to pay for your membership by credit card, please "Submit" this form so we have your information and refer to the CVARC website for other payment options. Dues may also be paid by mail or in person at club meetings using cash, check, credit card, or Venmo. Email info@cvarc.org if you have questions about club membership.
Membership Status

RenewalsNew Members
Start Date

MonthDayYear
Date

MonthDayYear
Membership Type

Single ($20/year)Two Year ($32 total, $16/year)Three Year ($48 total, $16/year)New Ham/Student ($10/year)Family ($25/year)
Membership Type

Single ($20/year)Two Year ($32 total, $16/year)Three Year ($48 total, $16/year)New Ham/Student ($10/year)Family ($25/year)
List Family Members Names/Call Signs (Family Membership Only)
Membership Price
Adjusted Month
Remaining Months
Prorated Amount

Payment Amount

USDDescription

Credit Card

Should be Empty: