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MEMBERSHIP APPLICATION & HISTORY SHEET NO.

THE AMERICAN SOCIETY OF WIRELESS PIONEERS OF THE SEVEN SEAS, INC. � !,.,.,::::.,.•.··'· .:.: ... .: .... :.:.: .. . :::.:.': ... . =.: •• .-.:: .•. .:.: .. ::':::.:,;· ·:r' .. _._. · ·: · · ·:·:· ·:: ·:,·,···,-: ·:: · · ·,- ·,·: · ·,·:-:-.:,:�::: P. o. Box 5 30 Santa Rosa, Cal. 95402 USA ···············❖·•· • • • • • ·: • • ·:: • ···:·:,· • • • ·: ·.:::.:t.: .. . :::: .. _ .•. _:;;.'.-.:.:.·.· .. :. _ :• .. : ... _: ••• =.::::::.:.:. : . .:::::.:.:::.:.:::,

I hereby apply for •� 1 membership in the Society of "WIRELESS PIONEERS" ( •) and certify that I meet membership requirements for classification marked below, by having held a commercial U.S. Gov•t. operator's license and having been employed as a wireless(radio) telegrapher at a ship or shore station, handling commercial traffic by c.w. code. (Military operators are eligible if they can document service at stations which have handled a sizable volume of "PG" traffic). I agree to furnish records or documents if requested by the Membership Committee. I agree to keep my address current at all times and acknowledge failure to do so will be sufficient grounds to drop my membershi.p. (•Short title). £.Signed .......•....... • .

..

VET�H.AN. _:i_ SPARK GAP PIONEER (Servic� prior to 1915 (Service 1926 to 1935 incl.

PIONEER (Service 1915 to 1925)

. 1-v� /;e------,,---G �en ,Name

. J)a 1,1 C:f,v UIIID� City 7 7

PROFESSIONAL ASSOCIATE (Service after 1935)

L.G Sine Wife

( ) Tph (Area) No.

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WIRELESS OR RADIO: S.5 � _D _a_t _e_f_i _ r_s_t_l_i_s_c _e _n_s_e Date assigned 1st ship _N _a_m_e __ s_h_ i�p-s-tn ________ Call

Navy or military assignment where ''PG" traffic handled (attach documentation)

SHIP OR SHORE STATION/S WHERE YOU HA.VE SERVED:

FROM TO NAME SHIP/SHORE ST"?t •. 1 FROM TO NAME SHIP/SHORE STN./' -/0-/ 'L 3-'-.o-l"t SS � � 1> ________ "'"'T"" ____ 'l"'r---�

AMATEUR ACTIVITIES

FIRST CALL A z DATE _/ 9....._c_.9....__ PRESENT CALL ____ WORK FREQUENCIES

RADIO ORGANIZATION YOU BELONG TO:

MEMBER "CQD 1 ers CLUB? (Those who have sent CQD or SOS and/or abandoned ship)

NAME SHIP 'S, � DATE SOS -,1,1-=-----(Circumstances on reverse side)

WILL YOU SEUVE AS OFFICEH OR DIRECTOR ON BOARD OF GOVC:RNORS IF NOMINATED? (Please use reverse side or additional B¼x:11 11 sheet/a for additional bio�raohical data. \Ye may use in future issues of "PORT 0 1 CALL" et cetera).

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NO. Jig- st,f DATE

**************** SOCIETY OF WIRELESS PIONEERS INC I!\ *******111111Ullllllllllllllllllllllllllllllllnlllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll P. 0. Box 530 Santa Rosa, Cal. 95402 USA 011111111111111111111111111111111111111111111111111illllllllllllllllllllllllllllllllllllllllllllllllll

I hereby apply for "LIFE" membership in the Society of "WIRELESS PIONEERS"(*) and certify that I meet membership requirements for classification marked below, by having held a commercial U.S. Gov•t. operator's license and having been employed as a wireless(radio) telegrapher at a ship or shore station, handling commercial traffic by c.w. code. (Military operators are eligi ble if they can document service at stations which have handled a sizable volume of "PG" traffic). I agree to furnish records or documents if requested by the 1-lembership Committee. I agree to keep my address current at all times and acknowledge failure to do so will be sufficient grounds to drop my membership. (•Short title).

SPAHK GAP PIONEER (Service prior to

PION�R 1915

(Service 1915 to 1925

Signed,

(Please type or print)

r----..-=-...:.....,,--�--.---. i; fS /4(: iJJI w,. L.. ,6. . h 'f Qj__ven N�e Initial Nickname Sine Wife

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tree tor P.O. Number .-City/ / State� Zip Tph (Area) No.

WIUELESS OR RADIO:

Date first liscense Date assigned 1st ship Name ship/stn Call

Navy or military assignment where "PG" traffic handled (attach documentation)

SHIP OR SHORE STATION/S WHERE YOU HAVE SERVED:

FROM TO

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NAME SHIP /SIIOIIB STN.

Se<e �j,,,"rer

FROM TO NA?-U!; SHIP /SHOHE STN.

(Additional - use reverse side.)

AMATEUR ACTIVITIES

FIRST CALL i\ Z DATE f' }9 / PRESENT CALL WORK FREQUENCIES

RADIO ORGANIZATION YOU B8LONG TO:: [?O MEMBER "CQD 1 ers CLUD? (Those who have sent CQD or SOS and/or abandoned ship)

NAME SHIP DATE SOS (Circumstances on reverse side) -------.,...,,...,,...,u,.,.,,...,,...,,.,,,.,,,...,,.,,,.,,,.,,,...,,.,,,.,,,.,,,...,,...,,...,,...,,...,,...,,...,,...,,...,,...,,

WILL YOU SEHVE AS OFFICEH OH DIIlliCTOH ON BOAHD O:F' DIRECTORS IF NOMINATED ? ... fo (Please use reverse side or additional B¼xll" sheet/s fo r additional biographical data. \Ve may use in future issues of "PORT 0' CALL" et cetera). \--==-=-D-

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