ARES REGISTRATION

Call Sign (use CAPITAL letters)*
First Name:*
Last Name:*
Main E-mail:*
Alternative E-mail:
Home Phone:
-
Personal Cell Phone:
-
Can you receive text messages on your personal cell phone?
Service Provider:
Work Phone:
-
Work Cell Phone:
-
Can you receive text messages on your work cell phone?
Service Provider:
Residential Address:*
Mailing Address: If different from Residential Address

(Check all that apply)

HF BASE
50 MHZ BASE
144 MHZ BASE
220 MHZ BASE
440 MHZ BASE
Can you operate from home if mains power is not available?
Approximately how long can you run your station without mains power?

(Check all that apply)

HF MOBILE
50 MHZ MOBILE
144 MHZ MOBILE
220 MHZ MOBILE
440 MHZ MOBILE
Are you a trained Emergency Communicator?
If yes, give details in the text box below. Briefly expand answers or add other pertinent info here.
I understand that the information provided will be reviewed by the ARES EDMONTON Planning Group and will be shared by other members of ARES EDMONTON for callout and contact purposes where necessary. Also that my information will only be used for ARES EDMONTON purposes. I also understand that the primary role of ARES EDMONTON is to provide backup communications to Agencies when needed. I agree to opt in to the ARES EDMONTON email program and wish to receive future emails from ARES EDMONTON. (Please acknowledge this statement before submitting your application)*
Word Verification: