MEMBERSHIP APPLICATION / MEMBER INFORMATION UPDATES

This form is used for two purposes. To apply for membership in the Florida Contest Group (FCG) or to update existing members’ information with the FCG. Note the FCG is no longer collecting dues.

To apply for membership in the Florida Contest Group, please completely fill out the information below, indicating Type as New Membership When applying for FCG membership, please make sure that all information is complete and correct.

For existing members’ whose information such as home addresses, email addresses, telephone numbers, license classes, etc., have changed, please fill out the information below, indicating Type as Membership Info Update. When updating your membership information, please make sure that all information is complete and correct.

* indicates required field

Type (New Membership / Info Change)*

Your Call:*

Name:*

Address:

Address 2:

City:

State:

Zip:

Florida County:

Country:

ARRL Member?*

YES NO

Email:*

Re-enter Email:*

Telephone (numbers only):

ARRL Section:

License Class:*

Grid Square:*

Website URL:

Send us a little information about your radio activities:

Date Of Birth: (only if under age 24)

The club treasurer is Taylor Plumblee. Please send her any donations you would like to make.

Taylor Plumblee
4719 Fontana Street
Orlando, FL 32807