EmailMe Form - ONLINE MEMBERSHIP APPLICATION FORM

Application Type *

Type Of Member *

Associate=For New Individuals or Club with Amateur Radio License.
Student=For Individuals less than 18 Years Old.
SWL=For Individuals without an Amateur Radio License

AMATEUR RADIO CALLSIGN *

Fill in "SWL" if you do not have a callsign

PERSONAL INFORMATION

Full Name or Club Name *

Valid correspondence or mailing address required.

Home or Club Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Nationality *

Gender *

IC Number/Club ROS Number *

Eg: 611228135126
*Do not enter space or dash.

Email Address *

*Required for all future activity correspondence.
**Enter your introducer's email address if do not have own email address.

Phone Number *

Valid Mobile Phone number for all correspondence.
Eg: 0128284086

Are you a member of any Amateur Radio Club ?
If YES, Which Club and Position:- *

Employer & Occupation *

Introduced and supervised by:-
NAME, CALLSIGN *

Passport Size Photo Upload (For New Member Only) *

*jpg, pdf, gif, jpeg, tif files only.

FEES

Fees Schedule:-
New Registration RM20.00,
Ordinary Member RM50.00/yr,
Associate Member RM30.00/yr,
Student RM5.00/yr *

New Associate (RM65.00) Registration + Membership + Badge

New Student (RM5.00)

PAYMENT

Bank in to Public Bank Account No:3140268230
Amateur Radio Club Sarawak

Payment Slip Upload

*jpg, pdf, gif, jpeg, tif files only.

DECLARATION OF APPLICANT/MEMBER

I DECLARE THAT THE ABOVE INFORMATION IS TRUE AND CORRECT, AND THIS APPLICATION IS SUBJECT TO THE COUNCIL'S APPROVAL DURING THE NEXT COMMITTEE MEETING.
I SHALL FOLLOW ALL RULES & REGULATIONS AS PER THE CONSTITUTIONS OF AMATEUR RADIO CLUB SARAWAK. *

I Agree