Southern California Monitoring Association
MEMBERSHIP APPLICATION
Attention: As of December 12th, 2007, after 11 years the club must rise the yearly dues to $20 if you have a computer and $30 if you have no
computer. The club has always tried to do their best for the membership but we to must pay more for the items that are used to keep the club going.
We now also offer the LIFETIME membership at $150.00 this is a great deal.
( Please make your Check or Money Order to: "R. Di Fiore" )
S.C.M.A. Att: Rick Di Fiore 3758 Barry Avenue Los Angeles, California 90066-3204 [Please allow 30 days replay by mail – E-Mail 24 Hours]
Type of Membership: o $20 1Year o $30 1 Year o $150 Lifetime
Please sign application form at bottom of sheet... not valid if blank and will be returned to you.
Date of Application: _________________. First Name: __________________. Last Name: _______________________.
Mailing Address: ___________________________________________________________________________________.
City: ____________________________. County: __________________________. State: _______. Zip: _____________.
Day Phone: ______________________. Night Phone: ______________________. Cellular: ______________________.
E-Mail Address: _____________________________________________________.
Please answer question below.__________________________________________________________
Amateur Radio Call Sign: _______________. Class of License: _____________. How many years Licensed: ______.
What Ham clubs do you belong to: 1.__________________________________________________________________.
2. ________________________________________________. 3. _____________________________________________.
What do you like to monitor: o L.A. Police o L.A. Sheriff o Riverside Sheriff o San Bernardino Sheriff
oSan Diego Sheriff o Santa Barbara Sheriff o Ventura Sheriff o L.A. City Fire o L.A.Co. Fire
o Orange Co. Fire o Riverside Co. Fire o San Bernardino Co. Fire o San Diego Co. Fire
o Santa Barbara Co. Fire o Ventura Co. Fire o Federal Agencies o U.S. Military o Marine Radio
o News Media o Aircraft – Commercial o Aircraft – Military o Business o Industrial
Other_____________________________________________________________________________________________.
Signature: _______________________________________.
DO NOT WRITE BELOW THIS LINE _________________________________________________________________________________
Membership ID - S.C.M.A. _________________.
Application Approved by: _________________________________. Date: _________________.
Notes: ____________________________________________________________________________________________.