INDIANAPOLIS RADIO CLUB MEMBERSHIP Form.... Please return this application request to any club officer at any meeting or mail to: IRC Treas. Judy Gardner-AA9GW; or mail to ; 509 Hardin Blvd, Indianapolis , IN , 46241 Make checks Payable to : Indianapolis Radio Club…. ------------------------------------------------------------------------------------------------------------------------- Name: ______________________________ Call: ___________ License Class ___________ Address: ______________________________________________________________ City: ___________________________ State: ________ Zip: ____________________ Email Add. : __________________________________ Phone: _____ - ______________ ARRL Member: Yes No (circle one ) Official use : [] Dues paid ____________ [] Card Issued [] I [] F [] L Tracking [] Sect. [] Treas. [] News editor [] Pres. [] ITC front Desk Form date: 12 dec 2005