"When all normal means of communications fail . . . . . you make the difference"



Your Personal Info



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: 



Preferences


Do you have an EMERGENCY SERVICE BADGE?  

**Preferred order of call-out  



Your Emergency Station


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: