New Jersey Institute of Technology
Amateur Radio Club, K2MFF
416 Faculty Hall
(973) 596-3505 / k2mff@njit.edu
http://web.njit.edu/~k2mff
ASSOCIATE MEMBERSHIP
First Name:_______________________________ M.I.:______ Last:_______________________________________
Address: Street:______________________________________________ City:_______________________________
State:____ Zip Code: ____________ Sex: (Please Circle One) MALE
Telephone:
Home: (
FEMALE
) _____________________ Work / Cell: (
) ______________________________
E-mail Address: _______________________________________________________________
Personal Web Page: ____________________________________________________________
License Class Currently Held: (Please Circle One)
Extra
General
Technician (w/ Code)
Technician (No-Code)
Non-Licensed
Call Sign: __________________ Year Licensed: ____________________
Associate Membership to the NJIT Amateur Radio Club, K2MFF, is hereby granted to, ___________________________ as
approved by all Executive Board Members. This person shall have the ability to operate within the Club Room while other
club members are present and/or any Executive Board Member is present. He / She shall have use to all the working
equipment within the clubroom as allowed by His / Her Operator License Class.
Signature: ___________________________________________________
Date: ___________________________
APPROVAL DATE: ___________________
JMS
AWM
(KC2OSZ) 9 / 07 President :___________________________________ (James Slocum)
(K2HAV) 9 / 07 Vice President: _______________________________ (Adam Melber)
SJK
(KC2PBN) 9 / 07 Secretary :___________________________________ (Scott Kachmar)
GJG
(KC2OVM) 9 / 07 Treasurer:___________________________________ (Gregory Gadomski)
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