Membership Application

Development Version

This application form is currently under development. Submissions are not being processed at this time.

Thank you for your interest in joining the Over The Road Amateur Radio Club. Please complete the form below to apply for membership. All fields marked with an asterisk (*) are required.

Personal Information

Full Name *

Amateur Radio Callsign *

License Class *

Email Address *

Phone Number

Location Information

Street Address

City

State/Province

ZIP/Postal Code

Country

Grid Square (if known)

Amateur Radio Information

Years Licensed

Operating Modes (check all that apply)

APRS Callsign (if different)

Brief Bio / Ham Radio Interests

Confirmation

I agree to abide by the OTR-ARC club rules and code of conduct

Note: Form submission is currently disabled as we are in development.

Important Notice

Membership Application

Development Version