Central Scotland FM Group

Membership Application / Renewal Form

• If you are renewing your membership and there haven't been any changes to the information which we already have, then mark the address area as "NO CHANGE". If you have changed callsign in the last year please give us a note of your previous callsign.

Call-sign:_________________            Old Call-sign:_________________

Name:_______________________________________

Name used in QSO:____________________________

Local repeater:_________________

House Name / Number:___________________

Street:_________________________

Town:________________________

District / City:_______________

Postcode:__________________

Telephone (optional) ________________

Email (optional) ___________________________________

(newsletter is available in .pdf format, and will be sent by e-mail if requested.)

Membership Rates

• Ordinary membership: £12.00 per year
• Full time students under 19 years old: £6.00
• Family membership (when all have the same surname and address): £20.00

Subscription Fee Enclosed: _______

{Donation:____ }

Please make cheque or postal order payable to "CSFM Group" and post along with this form to:

Crawford Ross, 16 Glebe Crescent, Airdrie, ML6 7DH