NEVADA AMATEUR RADIO REPEATERS, INC.


NEVADA AMATEUR RADIO REPEATERS, INC. (NARRI)

LAS VEGAS IRLP USERS GROUP APPLICATION

 

Name ______________________________________________Call Sign ___________ License Class____ Expires __________ ARRL: Yes No

Address____________________________________________________________________________________________________________

Telephones:  Home ______________________  Work ________________________  E-Mail __________________________________________

Why do you want to affiliate with NARRI? ___________________________________________________________________

______________________________________________________________________________________________________

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What talents or equipment can you  contribute  for the  good of  NARRI ?  ______________________________________________

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Are you willing to support NARRI fund rasing activities? Yes, If No explain ______________________________________________

Are you willing to support emergency services activities? Yes, If No explain  ____________________________________________

Suggested annual donation: Check or money order for $100 payable to  NEVADA AMATEUR RADIO REPEATERS, INC Mail to: 395 Peaceful Street, Las Vegas, NV 89110. Phone 702-452-4412

I release and hold harmless Kent B. Johnson and NARRI from any liability at all times in the future, with or without my affiliation to the users group.  I agree not to disclose private information such as system control information to a third party now or at any time in the future. I understand that the system equipment is fully owned by either Kent B. Johnson or NARRI. Revised 7/5/04.

Signature of Applicant ___________________________________________ Date _______________