Kentucky ARES District 5 ARES Registration
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Kentucky ARES District 5 ARES Registration:
Thank you for volunteering for your community and registering for Amateur Radio Emergency Service. This form will be forwarded to your local ARES coordinator and to the DEC of your district and ASEC of your region.

By submitting this form, you attest that all information is complete and accurate.
Name:*
Email:*
Callsign:
License Class:
Address:
City/St/Zip:
County:
    
Day Phone:

Evening Phone:
Cell Phone:
ARRL Member:
 Yes No
Amateur Radio Organizations You Are A Member Of:
Please list the bands you can work: (Check all that apply)
Data:
 HF VHF/UHF 1.2 GHz
Packet:
 HF VHF/UHF 1.2 GHz
CW:
 HF VHF/UHF 1.2 GHz
SSB
 HF VHF/UHF 1.2 GHz
FM
 HF VHF/UHF 1.2 GHz
Other:
 HF VHF/UHF 1.2 GHz
What Bands Do You Have Emergency Power For?
HF VHF/UHF 1.2 GHz
Please describe your qualifications: (experience, and/or interest)




Concept and Design Copyright 1993-2012 Pat Spencer, KD4PWL - All Rights Reserved
Return Home to KYHAM About KYHAM KYHAM User Forums The KYHAM Email List KY ARRL Links of Interest to KY Amateurs Find local aamteur radio contacts Amateur Radio Emergency Communications Kentucky Amateur Radio News Search the KYHAM Site How to help KYHAM accomplish its mission