Fourpak Packet Radio Group

Membership Application Form

If you would like to join FOURPAK, please print out the following form, fill in your details, and send it to the secretary, along with a cheque for seven pounds, made payable to "Fourpak Radio Club".

Your details will be considered strictly confidential, and will only be used for contacting you about club matters. They will not be divulged to anyone outside the committee.

The form includes a section where you may tell us about your areas of interest, and list any special skills which you might like to make available when working on group projects (e.g. you might be a microwave expert, or be able to climb ladders or make things, or you may be good at organising). The section is completely optional.

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Four Counties Packet Radio Group: MEMBERSHIP APPLICATION


Fourpak Treasurer,
74 Walker Avenue
Stourbridge,
West Midlands.
DY9 9EL


Please enrol me as a member of FOURPAK.  I understand that the details
I have supplied below will be considered confidential, and will only
be used for contacting me about club matters.

I enclose a cheque for seven pounds, made payable to "Fourpak Radio Club".



Callsign____________  Mr/Mrs/Miss/Ms/(other_______)   Initial(s)______

First Name_____________________   Surname_____________________________

Address_______________________________________________________________

       _______________________________________________________________

       ______________________________________    Postcode_____________

Email: _______________________________________________________________

Phone__________________________     Date_________________


Interests / Skills_____________________________________________________

_______________________________________________________________________

_______________________________________________________________________


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