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B-E-A-R-S Sign Up Application (Click for printable version) First Name: Last Name: Member of ARRL: Yes:     No:     Call Sign: (if member of ARRL): Phone: Cell Phone: Email: Fax Number: City: State: Zip Work-Place: Work Phone: What type of radio activities are you most interested in: (check all that apply) 2-Meter, 440 Public Service and/or emergency communications Multi-state communications, such as Cactus, Interstate Intertie IRLP (“dial” different places in the world on your radio, via radio networks and the internet) DX or Long Distance NVIS (or “nearer” Long Distance, such as SLC, or Rexburg Please list the kind of radio(s) and antenna(s) that you have now. What radios/antennas would you like to have in the future, if the radio club could give you some help with installation? Please type the characters exactly as you see them in the image below:

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