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In Memoriam - AD4PT
Updated June 3, 2Ø23 1246 CDT
USCG Amateur Radio Club Registration and Information Update Form
Membership is FREE but open ONLY to those who are serving on active duty or have served in the USCG/USCGR and have a valid amateur radio license.
Coast Guard Amateur Radio Club Registration & Information Update Form
Name Call Sign (Required)
Street Address Apt #
City State Zip Code
Phone Number
E-Mail
Previous Call Sign(s)
COAST GUARD BACKGROUND (Required)
When/where did you enlist?
When/where were you retired/discharged?
Rate/Rank at retirement/discharge.
CG CW Operators Assn. member? Yes No If yes, ZUT Number?
Duty assignments from boot camp on. (Use day/month/year if possible & rate/ranks at each duty station. Please include all service schools & class numbers. Much information may usually be obtained from the back of your discharge certificates).
Ham Station description:
Special Interests/Hobbies: