CARROLL COUNTY MD - ARES/RACES

Ver 2.0.0 © Copyright CircleSoftware 2008

Thanks for being a part of CARET! (Carroll Amateur Radio Emrgency Team)

Plese complete this form. Click on Submit when you are ready to send.

If you are renewing you only need to fill in any changes since last
year and click the "Renewal" box. REMEMBER to send your name, call, and e-mail address
.
Thanks & 73 de N3SB/Steve EC Carroll County, MD.

Last Updated:

           Renewal

Your name (Last, First):

  Call:

Address:

City:     MD     Zip:

Home Phone:      Work Phone:      Cell Phone:

Email address:

License Class:      (Novice, Tech, Tech+, General, Advanced, Extra)
Year your were FIRST licensed (yyyy):      Present license expiration date (mm/dd/yyyy):

Emergency Information - in case of injury:
     Please notify:      Phone1:

     Phone2:      Phone3:

     Allergies or other:

     Critical medical information:

  

Appointments: OBS ORS OES AEC EC

  

Station Capabilities:

2 Meter (VHF/FM) Analog Voice: Home Mobile Portable Deployment Kit
2 Meter (VHF/FM) Digital Voice: Home Mobile Portable Deployment Kit
2 Meter (VHF/FM) DATA (Packet): Home Mobile Portable Deployment Kit
70 cm (UHF/FM) Analog Voice: Home Mobile Portable Deployment Kit
10 meter (HF/FM) Analog Voice: Home Mobile Portable Deployment Kit
10 meter (HF/SSB) Analog Voice: Home Mobile Portable Deployment Kit
Multi-Band High Frequency SSB (>50w): Home Mobile Portable Deployment Kit
Multi-Band High Frequency SSB (QRP): Home Mobile Portable Deployment Kit
Multi-Band High Frequency Data (Winlink): Home Mobile Portable Deployment Kit
Citizen's Band (27 MHz): Home Mobile Portable Deployment Kit
Multi-Use Radio Service Band (151-154 MHz): Home Mobile Portable Deployment Kit
Famil Radio Service/GMRS: Home Mobile Portable Deployment Kit
Back Up / Emergency Power: Home Mobile Portable Deployment Kit


Vehicle Information - The one you would use in an emergency
Year (yyyy):       Make:       Model:
Registration Plate:       State:       4 Wheel Dive:


Call Out Availability
Weekdays Daytime:       Weekdays Evenings:       Weekdays Overnight:
Weekends Daytime:       Weekends Evenings:       Weekends Overnight:

  

Certificates:     NIMS (IC 700) ICS (IC 100) ICS Supervisor (IC 200)
  CERT NPR/NRF (IC 800) NWS Skywarn
  ARRL-AREC (EC-001) AREC (EC-002) AREC (EC-003)
  CPR/First Aid (Any Level) AmRed Cross MassCare AmRed Cross Shelter Ops
  County RACES ID Issued    

 

Interests?

(QRP, contesting, etc.)

 

Skills?

(foriegn language, building/repair radios, etc.)

 

HOME Return to: previous page