Michigan VHF-UHF Society New Member Information				Date _______________

Name:  ______________________	Callsign:  _______________________

Home Phone Number:  _______________		ARRL Member?  Yes __ or No __

Street Address:  _________________________________________________

City, State and Zip Code:  ___________________________________________

Home QTH 6-digit Grid Square: ________ Other Grid Squares You Activate:  ______________

What Bands do you operate?  Please note the amount of power you have for each band.

_________	6m		_________	2m		_________	1.25m

_________	70cm		_________	33cm		_________	23cm

_________	13cm		_________	9cm		_________	5cm

_________	3cm		_________	1.2cm		_________	6mm	_____ above 75 GHz

Are you on the Internet? _________	e-mail address: _____________________________________

Is it okay to send club-related material to this address? ____________________

Is it okay to publish your e-mail address on a club web page? _______________

What is your web home page URL?	________________________________________

Are you subscribed to the Club Reflector (Mailing List)?	____________________

Would you like to elect officers in person at a meeting, by postal mail, or would you 
prefer to use e-mail and/or the web?	______________________________________

What contests do you regularly participate in?
______	ARRL January VHF Sweepstakes
______	50 MHz Sprint
______	144 MHz Sprint
______	222 MHz Sprint
______	432 MHz Sprint
______	Microwave Sprints (Enter “S” for Spring and/or “F” for Fall)
______	Michigan QSO Party
______	ARRL June VHF QSO Party
______	CQ WW VHF Contest
______	ARRL UHF Contest
______	ARRL 10 GHz and Up Cumulative Contest
______	ARRL September VHF QSO Party
______	ARRL International EME Competition	
______	ARRL 10m Contest

Other Contests:  _________________________________________________

What classification do you typically operate as in the above contests? (ie: Rover, Single 
Op, QRP/Portable, etc.):

What areas of Amateur Radio are you currently involved, or interested in?  (ie, 
Contesting, Home Brewing, Transmitter Hunting, antenna design involving the higher 
frequencies, EME, etc.)