The Radio Amateur Telecommunications Society
                   Membership Application
            
            
Name:__________________________    Callsign:______________

Address:_______________________

State:_________________________    Zip:____________

Home Telephone:  (     )     -     OK in roster ?      Y / N
                                   OK on air ?         Y / N
Office Telephone:(     )     -     OK in roster ?      Y / N
                                   Ok on air ?         Y / N

Local/Home BBS:
BBS is what type (PRMBS/MBL/RLI/Other):
Local Network (ROSE/NetRom/TheNet/DIGI):
Local Network Address:

TNC/PAD:

Radio(s):

Computer(s):

Interests:


Comments:





Please enclose a donation of $ 25.00 and send to:

          The Radio Amateur Telecommunications Society
          206 North Vivyen Street
          Bergenfield, NJ  07621

For  further  information contact Gordon Beattie,  N2DSY  at
the KD6TH PRMBS or at 201-387-8896.