Member Registration Form

Submitting this application means that you agree to abide by the Constitution and Bylaws of the CW Operators Club, as well as decisions rendered by the Officers and Board. Your membership number will be issued and you will considered a member upon receipt of your dues payment. Note that payment of dues must be in U.S. dollars via PayPal or via bank check drawn in dollars on a U.S. bank and sent to the Treasurer.

Name*
First Last
Call sign*
Name used on the air
Email*
Alternate Email
Mailling Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Year licensed
Previous calls
Birthdate
MM slash DD slash YYYY
Website
Current occupation or occupation before retirement
Primary phone #*
Is this a cell or mobile phone?*
- Yes
- No
Secondary phone #
Spouse/partner name
Ham radio interests besides CW
Other radio club memberships
Current station/equipment
Tell us more about you