Haldimand Norfolk Amateur Radio Club Membership Application

 

 

Name:                                                        Call Sign:

Address:                                                    City:                              

 

Province:                                                   Postal Code:

Phone Number:                                         E-Mail:

Amateur License Class: □ Basic    □ Basic w / Honors    □ Advanced


My interest’s are:


□ H.F. - SSB

□ Satellite

□ H.F. – C.W.

□ Kit building

□ HF-RTTY

□ Contesting

□ HF-DIGITAL

□ Mentoring

□ VHF & UHF

□ Need Mentoring

□ Repeaters

□ Mobile communications

□ APRS

□ Field Day

□ ARES

□

 

Membership –  □  Single  rate  $ 30.00 CDN

                           □   Family  rate $ 35.00 CDN

Membership application and payment can be sent to Gerry - VE3DYY at VE3RND@gmail.com

 

Date: (yyyy/mm/dd): _________________________________


Haldimand Norfolk Amateur Radio Club


Privacy Disclosure and Consent


The Haldimand Norfolk Amateur Radio Club has adopted a Privacy Policy that we believe is consistent with the Personal lnformation Protection Electronic Documents Act (PIPEDA). The full policy document is available on the club's web page at www.VE3HNR.club.

A written copy may be obtained by requesting one from the club Secretary.

ln summary, the club collects information that we feel we require to facilitate your enjoyment as a member. We safeguard that information and promise to not disclose it without your informed consent. The club will not sell or lease your contact information.
We will not release your contact information to any other third party without your consent.
lf you have provided an e-mail address, we will use it to send you club related messages, including newsletters and bulletins. Your e-mail address will not be visible to any other recipient. Please read the following carefully and give consent where agreeable.

 


The Haldimand Norfolk Amateur Radio Club (H.N.A.R.C.) requires that all members agree to abide by the clubs' Code of Conduct. The full document is available on our website,

 

H.N.A.R.C. members shall not do anything which is likely to intimidate, offend, insult, humiliate or discriminate against any other person on the grounds of gender, race, disability, age, religious or political belief. sexual orientation, social background, ethnic origin, education, language marital or civil partnership status or medical condition.


□ I give consent to have my call sign and name included in the H.N.A.R.C. Members Directory.


□ l give consent to have my phone number included in the H.N.A.R.C. Member's Directory.


□ I give consent to have my address included in the H.N.A.R.C. Member’s Directory.
□ I give consent to have my e-mail address given to other H.N.A.R.C. members when requested.


□ I give consent to have my phone number given to other H.N.A.R.C. members when requested.


□ I give consent to have my image published in the club newsletter and / or web page.

 

□ l, the undersigned, have read and accept the terms above, and agree to abide by the Haldimand Norfolk Amateur Radio Club membership code of conduct

Signed;