Request edit access
FSD-98 Wayne County ARES
Sign in to Google to save your progress. Learn more
Email *
Name *
Callsign *
Address
Mobile Phone number, please use format 313-313-3133 *
Alternate Phone number *
Emergency Contact: First Name & Best Phone Number
Base Station? *
Can your home station be operated without commercial power? *
Mobile or Portable Stations? *
Bands Capable of Phone QSOs *
Required
Do you operate CW? *
Do you have digital phone capabilities?
Can you operate with
FEMA Training Completed:
Other Relevant Training Completed, e.g. ARRL EC001, EC016, Auxcomm, COM-T, COM-L, Skywarn, CERT, ICS-300, ICS-400
Other Relevant Experience:
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms