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Taylorsville HAMnet - Emergency Amateur Radio Operator Information Submittal
This form is designed to connect you to the Taylorsville HAMnet which provides emergency Amateur Radio Operators for the City of Taylorsville.

* * * NOTE: Complete this form ONLY if you have RECEIVED your Amateur Radio license. * * *

By providing the information requested below, you will be added to or updated on the Taylorsville HAMnet roster. Your information will remain private and secured and be used for official purposes only.

With any questions, please contact the City's Emergency Manager, Ben Gustafson.
Phone: 801-963-5400 - Email: bgustafson@taylorsvilleut.gov
First Name *
Last Name *
Call Sign *
Street Address *
City *
Zip Code *
Cell Phone *
Type N/A if you do not have one.
Home Phone *
Type N/A if you do not have one.
Email Address *
Type N/A if you do not have one.
What level of certification do you have? *
Is your license current/active? *
Can you provide proof of your license? *
When did you first receive your license? *
If you are unsure, please provide your best approximation.
Would you like to be notified of and participate in upcoming events (training, exercises, etc.)? *
Which type of role would you prefer to fill during an activation? *
If requested to do so, would you be willing to deploy to neighboring jurisdictions to assist in emergencies? *
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