Indiana Section Amateur ARES Registration Form FSD98

Indiana Section Amateur Radio Emergency Services
ARES Registration Form FSD-98

INARRL Main	Indiana Section ARES Home	Section Emergency Coordinator	District Emergency Coordinators
Emergency Coordinators	Official Emergency Stations	Interested in an ARRL Field Appointments?	Monthly SEC Report
Monthly EC Report	Register with the ARES	Indiana Section Plan	Indiana ARES Appointees

AMATEUR RADIO EMERGENCY SERVICE
ARES Registration Form
Indiana Section

Instructions: Fill in the form as best you can. Do not press enter until you are ready to send the form. Use Tab or your mouse to move between input boxes. On the following page print a copy of the summary report for your records. All information collected on this screen will be used for ARRL Indiana Section ARES purposes only.

Name:
Call sign:
Mailing Address:
City, State ZIP:
County of Residence:
County of Employment:
Email Address:
Home Phone:
Work Phone:
Cell Phone:
License Class:

Check bands and modes that you can operate:

MODE

6
Meters

2 Meters

220
MHz

440
MHz

Other

SSB
CW
FM
DATA
Packet
Other Bands and Modes indicate below:

Can your home station be operated without commercial power? Yes No

Comments:

IN FSD-98 (01-2004)

Section Emergency Coordinator
W9AL w9al@arrl.net

Last update 06/05/2007

Indiana Section Amateur Radio Emergency Services ARES Registration Form FSD-98

Indiana Section Amateur Radio Emergency Services
ARES Registration Form FSD-98