• Name
• Email
• Home Phone
• Mobile Phone
• Membership Number
• HAM Callsign
• CASC-OR affiliation Yes No
• CASC-OR justification
• Address
• City
• Province
• Postal Code

• Name
• Email
• Home Phone
• Mobile Phone
• Membership Number
• HAM Callsign
• CASC-OR affiliation Yes No
• CASC-OR justification
• Address
• City
• Province
• Postal Code
• Name
• Email
• Home Phone
• Mobile Phone
• Membership Number
• HAM Callsign
• CASC-OR affiliation Yes No
• CASC-OR justification
• Address
• City
• Province
• Postal Code

• Name
• Email
• Home Phone
• Mobile Phone
• Membership Number
• HAM Callsign
• CASC-OR affiliation Yes No
• CASC-OR justification
• Name
• Email
• Home Phone
• Mobile Phone
• Membership Number
• HAM Callsign
• CASC-OR affiliation Yes No
• CASC-OR justification
• Name
• Email
• Home Phone
• Mobile Phone
• Membership Number
• HAM Callsign
• CASC-OR affiliation Yes No
• CASC-OR justification
• Name
• Email
• Home Phone
• Mobile Phone
• Membership Number
• HAM Callsign
• CASC-OR affiliation Yes No
• CASC-OR justification
• Address
• City
• Province
• Postal Code