ARES/RACES Registration Form Name:__________________________________ Call: ________________ Address:_____________________________________________________ _____________________________________________________ _____________________________________________________ ______________________________ County: ____________ Home Phone: (____)________________ Work Phone: (____)________________ e-mail: ________________________________________________ Circle all that apply: ------------------------------------------------------------------------ Appointments OBS, ORS, OES, AEC, VE ARES Equipment 75 AHr, 25AHr battery Other Emergency Equipment: (Erase the lines/bands below that you do NOT have.) Emergency Antenna 160, 80, 40, 30, 20, 17, 15, 12, 10, 6, 2, 220, 440, Emergency Field 160, 80, 40, 30, 20, 17, 15, 12, 10, 6, 2, 220, 440, Emergency Power 160, 80, 40, 30, 20, 17, 15, 12, 10, 6, 2, 220, 440, CW 160, 80, 40, 30, 20, 17, 15, 12, 10, 6, 2, 220, 440, FM 10, 6, 2, 220, 440, RTTY 160, 80, 40, 30, 20, 17, 15, 12, 10, 6, 2, 220, 440, SSB 160, 80, 40, 30, 20, 17, 15, 12, 10, 6, 2, 220, 440, Mobile 160, 80, 40, 30, 20, 17, 15, 12, 10, 6, 2, 220, 440, Packet 160, 80, 40, 30, 20, 17, 15, 12, 10, 6, 2, 220, 440, BBS 160, 80, 40, 30, 20, 17, 15, 12, 10, 6, 2, 220, 440, Ticket Novice, Technician +, General, Advanced, Extra ------------------------------------------------------------------------ Interests: _____________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Skills: (foriegn language, build radio/antenna, repair equipment?): ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Send to: Phil Karras, KE3FL 3305 Hampton Ct Mt Airy MD 21771-7201 or e-mail to: KE3FL@arrl.net