Address: City: State: Zip: County:
1 2345RANK YOUR RESPONSE CAPABILITY. 1 indicated that you will be called first; 5 means that you will be called last. Email Address: Day Telephone#: Evening Telephone#: Cell Telephone#: Pager Telephone#: Go Kit Available? I have a go kit. I do not have a go kit. Do you have net control station experience? I have net control station experience. I do not have net control station experience. Appointed position (If any): Specific training? Red Cross?ARRL EMCOM? Any special skills (don't be bashful)? Do you know your local ARES leadership and how to contact them? I know how to contact my ARES leadership. I do not know how to contact my ARES leadership. Are you available to serve in an adjacent county? I am available to serve in an adjancent county.I am not available to serve in an adjacent county. Repeater owners List your repeater callsigns/frequencies, indicate if Emergency Power is available. Listing here indicated your agreement for use of your listed repeaters for ARES/RACES operations and drills. Areas of interest:
Bands of Operation (More than one selection may apply)