Registration Form

Fishers Ghost Amateur Radio Club & Liverpool & District Amateur Radio Club

Amateur Radio Foundation Licence Course

or

Standard/Advanced Licence Course

______________________________________________

I wish to undertake the Amateur Radio Foundation Licence Course/attempt the Standard/Advanced Licence examinations to be held on a date to be determined and held in either Campbelltown or Liverpool districts.

My details are:

Name: ……………………………………………………………………

Address: …………………………………………………………………

……………………………………………………..Post Code:…………

Tel No:……………………… email address:…………………………………

Gender: Male/Female …….. Date of Birth:……………………………..

You will be notified of the next course dates as soon as sufficient candidates have registered to undertake the course. If you accept this date, we require your confirmation of acceptance and payment of the relevant Registration Fee below before the start of the course.

Fishers Ghost Amateur Radio Club Inc.

PO Box 35N,

Campbelltown North, NSW 2560

or

Liverpool & Districts Amateur Radio Club,

Box 4, Bathurst Street,

Greystanes, NSW 2145

or Direct Deposit as arranged.

You will be notified of the course dates as soon as sufficient candidates have registered to undertake the course.

Club membership: Please indicate whether you would like to join one of the amateur radio clubs with a X  in the box beside either Club. An application form will then be forwarded to you.