| ||
|---|---|---|
- Subject : (please choose)
- Your Call Sign:
- Your license class:
- Your Name :
- Your Address :
- City :
- Parish :
- State :
- Zip Code:
- Phone :
- Pager : Cell
- Email Address :
- Your website URL:
Do you have an EMERGENCY SERVICE BADGE?
**Preferred order of call-out
Please select your available operating Band/Mode combinations:
| Select all that apply: (specify capabilities of equipment in your possession, not license class privileges) | ||||||
| CW | FM | RTTY | SSB | MOBILE | PACKET | |
| 160 | ||||||
| 80 | ||||||
| 40 | ||||||
| 20 | ||||||
| 15 | ||||||
| 10 | ||||||
| 6 | ||||||
| 2 | ||||||
| 220 | ||||||
| 440 | ||||||
IF PACKET LIST YOUR PBBS:
LIST ANY OTHER COMBINATIONS:
- Can your home station operate without commercial power?
IF YES WHAT BANDS? 160 80 40 20 15 10 6 2 220 440 - Do you have spare batteries for your HT?
- Please list list any skills you believe to be of significant value to ARES:
Comments:
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