Amateur Radio Emergency Service


ARES Registration Form
Last Name First Name
Call Sign
License Class
Address
City State Zip Code
Email Address 1
Email Address 2
Home Phone Number
Work Phone Number
Cell Phone Number
Check ALL bands and modes that you can operate  :
Mode HF 6 Meters 2 Meters 222 Mhz 440 Mhz
SSB          
CW          
FM          
AM          
Packet          
SSTV          
Base          
Portable          
Mobile Operation          
Handheld (HT)          
Can your home station be operated without commercial power? Yes No
Signature Date
* Amateur Radio Emergency Service (ARES) * Indiana County * PA *
Please fill this form out and return it to Robert Zugates (KB3JOF) Indiana County EC - kb3jof at arrl.net

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