The OCRG Membership Form

Fill out the form below and hit the submit form button. Address information will only be seen by OCRG officials.

After you have submitted your form, mail your check or money order made payable to "CASH" to the address below. You will be notifed by either telephone or e-mail when your donation is received and your membership becomes active. Please include your callsign on your check.

If your browser/viewer does not support forms please use our printable membership form.

Ocean County Repeater Group
P.O. Box 525, Toms River, NJ 08754

Your Name Your Call
Street Address
State Zip Code

Home Phone
May we print this number in our Membership roster? Yes No

Phone number for Auto Dial (if full member)
E-mail or Packet address

License Class Year First Licensed

Are you a member of The ARRL? Yes No
Are you a member of ARES? Yes No
Other Amateur Organizations

CW SSB FM AM RTTY SSTV ATV Packet RACES Traffic MARS Contests Satellite DX Other

Bands Operated:
160 80 40 20 15 10 6 2 220 440 Other

$25 Full Membership (with Autopatch)
$15 Contributing Membership (without Autopatch)

-- Return to the OCRG homepage --

© 1996 Scott Holland