ARES Member Questionnaire

ARES Member / Station Capabilities

Callsign *

Office Phone

Primary Email

Amateur License Class *

License Expiration Date *

First Name *

Last Name *

Street Address *

City *

State *

Zip *

County *

City/State You Work In or None

Home Phone

Cell Phone

Secondary Email

Band/Mode Capability Information (F=fixed M=mobile P=portable)

160M (F)160M (M)160M (P)80-20M (F)80-20M (M)80-20M (P)WARC HF (F)WARC HF (M)WARC HF (P)10M (F)10M (M)10M (P)6M (F)6M (M)6M (P)2M (F)2M (M)2M (P)220MHz (F)220MHz (M)220MHz (P)440MHz (F)440MHz (M)440MHz (P)
CW
SSB
FM
AMTOR
PACTOR
Packet
Sound Card Modes
If other, please specify:

Emergency Power Information

160M80-20MWARC HF10M6M2M220MHz440MHz
Battery
Generator
Solar
Other
If other, please specify: