BASE MOBILE PORTABLE OTHER

PORTABLE GENERATOR
CAR BATTERY
SPARE CAR BATTERY

LONG POWER CABLE
FOR PORTABLE OPERATION
SOLAR POWER
HF BANDS

2M
220
440

SSB
AM
FM
CW
PACKET
RTTY
APRS (PACKET)
MAX POWER HF

MAX POWER VHF/UHF

EQUIPMENT  # XMITTERS

 

BASE

MOBILE

PORTABLE

OTHER

  
Please provide us with the following
information about yourself and your station: 

Are you a member of   

   SKYWARN     ARRL
I can operate my home station from emergency power: HFYES
      NO		 VHF YES
          NO
In the text box at the left, Tell us anything about your station that is not included in the above information.


License Class:    N     T      T+      G       A         E
Call:
Name:
Address:
City: State:
Zip:
E-mail:
Home Phone:
Work Phone: 
Cell Phone:     


When you have completed the above form, you may continue by clicking on the 'Send It' button to send your completed form to the Rensselaer County Emergency Coordinator - Jim Noble, K2ZP (EC)

If you want to reset or clear the form and start again click on the reset button

Designed by Tom Mathewson, KA2MYD