METRO-JACKSON ARES REGISTRATION FORM

If you are interested in joining MJARES, or if you want to update your
information, fill out this form. The information will be sent to your
EC (Ben Jones, AC5SU) and the appropriate AEC's roster.
We will acknowledge initial registrations and updates in 48-72 hours.

Check here if this is a NEW registration (NEVER been an MJARES member)

Check here if you are changing your callsign.
Please fill out the rest of the form to update the data base.

Enter your OLD callsign here:
(Enter your new callsign below.)

Personal Information:

First Name:		Last Name:
Callsign:		License Class:
Street Address 1:
Street Address 2:
City:		ZIP:

Home Phone:		Unlisted? Check for yes.
Work Phone:		Unlisted? Check for yes.
Numeric Pager 1:		Unlisted? Check for yes.
Pager 1 PIN:
Numeric Pager 2:		Unlisted? Check for yes.
Pager 2 PIN:
Cell Phone:		Unlisted? Check for yes.
Home E-mail Address:
Work E-mail Address:
Alpha Pager 1: Must be an e-mail address!		Unlisted? Check for yes.
Alpha Pager 2: Must be an e-mail address!		Unlisted? Check for yes.
Packet Address:

We're interested in certain capabilities. Which of these do you have?

Please fill out what you can. We can follow-up later if you have any questions. If you're unsure of your capabilities or how you can contribute to MJARES, stop here, scroll to the bottom of this form and send it in with only the personal information above. We'll give you a call! Don't forget. you can also check in to our weekly net on Sunday evening at 8:00 pm on the 444.000 repeater.

HF CW	Fixed	Portable	Mobile
HF Voice	Fixed	Portable	Mobile
HF Digital	Fixed	Portable	Mobile
2m FM Voice	Fixed	Portable	Mobile
440 FM Voice	Fixed	Portable	Mobile
VHF Packet	Fixed	Portable	Mobile
2m SSB	Fixed	Portable	Mobile
APRS	Fixed	Portable	Mobile (Tracker)

Please indicate if you have any of these weather station capabilities.

Do you have a weather station capability?	Kestrel 3000 or equivalent? Home WX station?
What is your availability to give weather readings? 24/7 (Covers all selections below) Mon-Fri days Mon-Fri evenings Sat-Sun days Sat-Sun evenings

Please indicate if you have any of these additional capabilities.

Do you have 4 wheel drive capability?	4WD Truck? 4WD SUV? 4WD Car/Van?
Which of these forms of emergency power do you have?	EP - Generator EP - Battery EP - Solar
Do you have mag mount antennas?	10m antenna? 6m antenna? 2m antenna? 220 antenna? 440 antenna? Dual Band antenna?
Other antennas of interest?	Spare J-pole? Spare 2m beam? Spare 70cm beam? Spare HF vertical? Spare HF dipole?
Portable generator?	Portable generator?
Portable mast height (if available)?	ft

What is your availability? Check all that apply:

Not everyone works a normal 8-5 weekday job. Still, select the availability that most closely matches your schedule.

24/7 (Covers all selections below)
Mon-Fri days
Mon-Fri evenings
Sat-Sun days
Sat-Sun evenings

What is your expected level of participation? Check all that apply:

First Responder
Exercises
Public Service
Emergencies
Net Control Station
MJARES Staff
Training

Anything else you want to tell us? Be kind!

Metro-Jackson Amateur Radio Emergency Service http://www.qsl.net/ac5su
Comments, suggestions to Ben Jones, AC5SU