Kentucky ARES Station Appointment Application

This application is based upon ARRL Form FD-156. Please understand that you need to complete the entire form so that it may be considerred.

The positions of ASEC, DEC, ADEC, EC and OES require active ARRL membership. The AEC position is recognized, but does not require membership. Please refer to the links above to learn of other requirements for the position you wish to apply for.

KY ARES Coordinators are required to submit applications for it to ARRL HQ for verification.

Kentucky ARES Station Appointment Application:

Type:

Renewing my KY ARES appointment for 2008.
I am a new applicant applying for a position.

Name:

Callsign:

Address:

City/ZIP:

Email:

County:

Phone::

Day: Evening: Cell:

Position:

OES AEC EC ADEC DEC ASEC

ARRL Member?

Yes No (ARRL HQ verification required on certain positions)

License Class:

Previous ARRL Appointments:

Current ARRL Appointments:

List current amateur radio club memberships:

Please indicate what bands you can operate the following modes: (Check all that apply)
CW:	80, 40, 20, 15, 10, 6, 2, 440 MHz
SSB:	80, 40, 20, 15, 10, 6, 2, 440 MHz
Digtial:	80, 40, 20, 15, 10, 6, 2, 440 MHz
Mobile:	80, 40, 20, 15, 10, 6, 2, 440 MHz
FM:	80, 40, 20, 15, 10, 6, 2, 440 MHz
Can your home station operate on emergency power? Yes No
What Bands	80, 40, 20, 15, 10, 6, 2, 440 MHz

Please select training you have completed below:
KY ARES, ARRL ARECC FEMA IS-100, FEMA IS-200, FEMA IS-700, FEMA IS-800

Please list on any related experience: