NAQCC Membership Application

Already a member? Don't accidentally re-apply before first checking here.

Use the tab key or your mouse to move between fields; the ENTER key will submit the form.

If you encounter an error message when submitting, just send the required info in an email with the subject "NAQCC Membership Application" to database manager Brent, WT4U, at pix_email_wt4u or club president John, KK4ITX, at pix_email_kk4itx .

Your membership application will be echoed to the email address you provide.

Check back with us if you don't get an email with your member number within a week.

First and last name properly capitalized, e.g. John Ham
On-air name properly capitalized, e.g. Jack
Ham callsign using all capitals, e.g. W1ABC No callsign? Enter "SWL"
Email address We do not share this
Mailing address
City
State or province if you live in US or Canada, otherwise "NONE"
ZIP or Postal Code if you have one, otherwise "NONE"
Country
Grid Square 4- or 6-character, can be looked up here.	(optional)
If you have your own website, enter your URL Personal and ham radio-related, please	(optional)
How did you hear about us?