2020 Registration

Call-Sign (required)

First Name (required)

Last Name (required)

Email (required)

Licence Class (required)
NoviceTechnicianGeneralAdvancedExtraNone

Address 1 (required)

Address 2

City (required)

State (required)

Zip (required)

Primary Phone (required)
HomeMobile

Secondary Phone
HomeMobile

Date of Birth (required)

Equipment

VHF/UHF Voice
AnalogDMRD-StarFusionP25NXDN

VHF/UHF Data
APRSJS8CALLPacketWinlink

HF Bands
160M80M40M30M20M17M15M12M10MAll HF Bands

HF Data
JT65JS8CALLMT63Olivia/ContestiaPactorPacketPSKRTTYWinlink

Completed Courses
IS-100IS-200IS-700IS-800EC-001IS-120IS-200IS-230IS-240IS-241IS-242IS-244IS-288EC-016G-300G-400

By submitting this application, I affirm that the facts set forth in it are true and complete to the best of my knowledge and that I will abide by the code of conduct and meet the requirements within 90 days of application acceptance.
I understand that if I am accepted as a volunteer, any false statements, omissions, other misrepresentations made by me on this application, or failure to abide by the code of conduct and requirements may result in my immediate dismissal.