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Membership Application Form

If you would like to join our group please fill in the application form below and then copy and paste it into an email message, in the "to" field type "join@derbyraynet.co.uk". Your membership application will then be then be discussed by the committee for approval, and you will then be contacted. When you become a member of our group you will receive access to the rest of our web site which contains details about us and our events. Thank you for your interest in Derby Raynet. 

Please provide the following contact information:

First Name
Last Name
Callsign
Address
Address 
Address
City/Town
County
PostCode
Work Phone
Home Phone
E-mail
Do you know an existing member if so who?
 

By submitting this application form you have agreed to your details being used by the committee on behalf of the group, your details will not be passed  or used outside of Derby Raynet.  Also you agree to participate in at least one event per year.