Oregon Tualatin Valley Amateur Radio Membership Application Form

Please mail your payment to:
OTVARC
PO Box 5471
Beaverton OR 97006-0471

Attention: Membership

Name *

First

Last

Your Call Sign

Your License Class

Your Email *

Phone

Address *

Address Line 1

City

State

Zip Code

Spouse/Significant Other Name

First

Last

Spouse/Significant Other Call Sign

Is Your Spouse/Significant Other an OTVARC Member?

Are you an OTVARC Life Member?

Your Birthdate

We will use this information to determine if you are eligible for Life Membership and to celebrate your life.

Are You an ARRL Member?

Do You Hold an ARRL Appointment?

Please enter the title and section

Are You an ARES Member?

Are You VE Certified?

Which Organization are you VE Certified?

If VE Certified by another organization, please include that in the next box.

VE Certified other than ARRL or W5YI

Please enter the other organization that you are VE Certified with. Thank you!

Please check below any interests that you have, would like to participate in or want to know more about.

Interests

Do you have any other interests not included above?

Please click on SUBMIT. You will be directed to another page where you can add another family member. Thank you!