2017 Copyright © Contra Costa Communication Club  |   Privacy Policy

Untitled Document

 

Contra Costa Communications Club, Inc.
P.O. Box 20661, El Sobrante, CA 94820-0661
An Amateur VHF/UHF Repeater Croup
A Non Profit Service Club



Date                        

Family Membership Application    



4C Member     Call Sign

Family Member

Last Name First Name    A.K.A 
   Call Sign       License        Email
    Address       City/St.          Zip
  Home Ph.   Work Ph.  Cell Ph.
       Packet        ARRL

Do NOT publish Adddress   Home   Work   Cell   Email  

The Communicator newsletter is sent as a .pdf file via 3-mail to each member/family.
If you do not have internet access The Communicator can be sent by mail.     Please send hard copy.


Family Membership Annual Dues = $20.00

Send check* payable to CCCC, Inc. along with completed application and photo copy of license to:


Contra Costa
Communication Club, Inc
P.O. Box 20661
El Sobrante, CA 94820-0661


In placing this application for family membership in CCCC, Inc., I agree to keep confidential all control codes and other data furnished to me by the club as confidential, in order to comply with and maintain security of “control” as required by the F.C.C.  I recognize the obligation of the club and the club Trustee to the F.C.C. and California State Corporations Codes. I agree to cooperate with the club Board of Directors and club Trustee in matters of operating policy in order to maintain the integrity of the club station license. I agree to abide by the constitution and bylaws of the corporation. I understand club membership ends automatically with license expiration. I understand the license suspension or revocation by the FCC will result in cancellation of club membership with no refund of moneys paid to the club.   

I have read and agree.    Please check box.



Signed   Date

Family Member Signature

Signed   Date

Member Signature (For Youth membership responsible adult must also sign.

 *Return check fees apply

Note:  For Memberships beginning after July 1 the first year Annual Dues are 50% of the above.


Conplete the application and Save As a web page. Email the file as an attachment to:.wa6kqb@comcast.net