New Jersey Knights of Columbus Amateur Radio Club

Online Membership Application

5 easy steps: Complete the answers for each question, then click the “Next” button.

MEMBERSHIP DESIRED (Select one.)

Full Member - Actively Licensed Amateur Radio Operator AND a Knights of Columbus Member in a council in New Jersey ($20/year) Associate Member - Knights of Columbus Member in a council in New Jersey and NOT presently a Licensed Amateur Radio Operator ($15/year) Honorary Member - Reserved for Priests and Deacons Only ($0/year)

TITLE (Select one from the Drop-down Menu below.)

First Name

Middle Initial (or Name)

Last Name

Preferred First Name or Nickname

HOME STREET ADDRESS

City

State

Zip Code

Personal Email Address

@ARRL.net Email Address (if applicable)

Phone

Can this phone receive Texts?

Date of Birth (MM/DD/YYYY)

Occupation (even if retired)

Highest Knights of Columbus Degree Received? (Select one from the Drop-down Menu.)

Current K of C Office(s), if any, and Past-Former Titles

Council Name

Council Number

Member Number

UPLOAD A SCAN OR PHOTO of your Knights of Columbus Membership Card (Supported file types .pdf, .jpg, .jpeg, .png, .tif and .tiff, Max size 4MB)

Parish/Church Name

Parish/Church City

Parish/Church State

AMATEUR RADIO CALL SIGN or Enter "None"

LICENSE CLASS

ARRL MEMBER?

No Yes-Annual Yes-Life

ARRL Member Number or Enter "None"

AMATEUR RADIO INTERESTS

AMATEUR EQUIPMENT or Enter "None"

OTHER HOBBIES OR INTERESTS

CERTIFICATION - I do express a willingness to abide by the Constitution and Bylaws of the New Jersey Knights of Columbus Amateur Radio Club, Inc. (NJKCARC)

Yes No

COMMENTS or NOTES, if any (When finished, continue scrolling down and click the "Submit Button". Please be patient - it takes a while to process.)