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?
___________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
What talents or
equipment can you contribute for the good of
NARRI ? ______________________________________________
______________________________________________________________________________________________________
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
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
Signature of Applicant ___________________________________________ Date _______________