Application for Membership
Southington Amateur Radio Association, Inc.
PO Box 873 Southington, CT. 06489
W1ECV/DV KB1AEV/R N1FNE/R
224.800 444.250 145.490 147.345 442.600 444.100 442.750 224.16
With the exception of 145.17 Southington – most repeaters sites are linked-throughout the state
Membership $15.00 Retired $10 Donation per year includes repeater use, Newsletters, Club function
Please accept this application for membership in the S.A.R.A. Inc. ( ) New ( ) Existing (Retired $10)
( ) I am not interested in membership but would like to participate in Civil
( ) I am already a member and this is only an update in the membership list for S.A.R.A. Inc.
Date of Application: __________
First - Middle - Last
Address: __________________________ __________________________ _____
Street Address - Town - State - Zip Code
Call: ________ Class of Call: _____ Phone Number (Home) _____________ (Work) _____________
The Southington Amateur Radio Association Inc. (S.A.R.A.) is actively
involved in Public Service Events and Civil Preparedness. We ask all of our
members to participate in whatever manner they can. Please take a moment to
fill out the short questionnaire below. Indicate the areas that relate to your
( ) I want to be involved in Civil Preparedness on a Club level.
( ) I also want to get involved with ARES and/or RACES.
( ) I have had emergency training, such as CPR, First Aid, EMT, etc.... Please list the training and the year that the training took place.
( ) I have a Four-wheel drive vehicle that I would be willing to use in times that would be needed by the Town/State (gas is free in times of emergency while you participate).
SPECIAL INTERESTS: The only way a club can serve its membership is to know each and everyone of you on a personal basis. The following are but a few items, please feel free to include any other activities and comments.
What are your favorite bands of operation?
What is/are your favorite mode/s of operation?
Are you an ARRL. member ? ( YES ) ( NO ) We need this information, as we need 51% of our membership associated for us to remain affiliated)