Boeing Employees’ Amateur Radio Society - St. Louis
Membership Application

Instructions:

  1. Fill out the on-line form below, then click the submit button.
  2. A copy of the signature form will be sent the the 'Home e-mail' address entered on the form below.
  3. Print out and Sign the form you received by e-mail.
  4. Send the signed form with your check, made out to “BEARS-St. Louis”, to: 
              Jared Corgan, W7AQB

Please Send completed form and check to W7AQB's QRZ.COM postal mail address.  


Dues are $20.00/year ($10.00/year if retired), should be paid before the first of the year, and are delinquent if not received by 1 February. Dues are prorated for new members and prorated refunds are given for withdrawn memberships.

 

Application Type:*

General Information


Member Type:*
Name:*
Call Sign (enter None if unlicensed):*
License Class:
License Expiration Date:
Year First Licensed:
ARRL Member:
VEC
Which Other VEC?
Address:*
Home E-mail:*
Home Phone:*
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Cell Phone:
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BEMSID:

Employees/GKN Employees/Contractors

Department:
Building:
Mail Code:
Shift:
Work E-mail:
Work Phone:
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Emergency Contact Information

Emergency Contact Name:*
Emergency Contact Phone:*
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