Buckeye Belles Application for Membership

Renewal _______ New Member _________ Year:20_____

Name________________________________ Call______________ Belle # ______ (if applicable)

Address___________________________________________________

City________________________________ State______ Zip_________

Phone______________ Unlisted (Y/N)___ Birthday______ (month/day only)

Email address: ________________________       web page: _____________________________

packet address:________________________

License class ____________       Occupation_____________________________

Married Y__ N___       Is Ohio YL, is OM a Beau? Y__ N__

If Y, OM's name/call _____________      OM's DOB ______

YLRL Member Y__ N__       ARRL Member Y__ N__

Other amateur radio clubs you belong to: ____________________________________________

Other Hams in Family____________________________________________

Other Activities and Hobbies____________________________________

In what way would you be interested in helping the Buckeye Belles
(please circle all areas you are interested in):

Net Control
Fund Raising
Officer
Burr Contributor
Annual Meeting
Annual Picnic
Contests
Flyers/Posters
Other (please list)_____________________________

(downloaded from the Buckeye Belles HomePage)

Dues are due by March 31st for the Belles. Use the application form above to mail in your dues with the appropriate amount to:

Jean Ruth, KB8YHN
192 N Pleasant St
Oberlin, OH 44074-1123
jruth@oberlin.net

Dues for the Buckeye Belles

Ohio Belles	Regular Member	$10
Out of State YLs	Associate Member	$8
Members residing at same address	Family Member	$1
DX YLs	DX Member	$11
OM of OHIO YL member only!	Buckeye Beau	onetime fee of$1
Subscriber	Subscriber Member	$8

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