VK QRP Club
CW Operators' QRP Club Inc.

On-Line Membership Application

Please complete this on-line membership application, the Club Secretary will respond to you via e-mail.

First Name:
Surname Name:
Callsign:
E-Mail**:
Address #1:
Address #2:
City:
State:
Country:
Post Code:
Comments:
Receive Club e-mails(Y/N):
Sponsor (if any) Name:
Sponsor Callsign:
Check Question 2 X 2 = Check Question MUST be answered correctly in order to proceed.
Submit-Email:

** Please be aware, only applications with VALID email addresses will be processed.

For YOUR security email addresses are NOT disclosed
to the general public.

Once my application is accepted, I agree to my details being held on the Club’s data base and my name, callsign, city, and country, being published.