Kaufman County Texas ARES Registration Form
Name
*
First Name
Last Name
Call Sign
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Home Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Work Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Mobil Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
License Class
*
Check bands and modes that you can operate:
Modes you can operate on HF
Single Side Band
CW
FM
Data
Packet
Other Modes
Mobil Operation
Modes you can operate on 6 Meters
Single Side Band
CW
FM
Data
Packet
Other Modes
Mobil Operation
Modes you can operate on 2 Meters
Single Side Band
CW
FM
Data
Packet
Other Modes
Mobil Operation
Modes you can operate on 222 Mhz
Single Side Band
CW
FM
Data
Packet
Other Modes
Mobil Operation
Modes you can operate on 440 Mhz
Single Side Band
CW
FM
Data
Packet
Other Modes
Mobil Operation
Modes you can operate on Other
Single Side Band
CW
FM
Data
Packet
Other Modes
Mobil Operation
Please specify other operating capabilities here
DMR , Fusion, Hotspots, APRS, Things of that nature.
Can your home station be operated without commercial power?
Yes
No
Type Your Full Name HERE
*
This is your Signature for this registration form
Today's Date Please
*
-
Month
-
Day
Year
Date
Please verify that you are human
*
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