CCARES Field Day 2017 registration
Date: June 24th-25th, 2017
Location: Culver City Fire Station 1 CCARES Radio Room
Contact us at (310) 696-1166 or ccares@ccares.net
Email address *
Name (first & last) *
Your answer
Call Sign *
Your answer
License Class *
Days and time periods you wish to operate.
In the spaces provided below, select the day (Saturday or Sunday) and the start and stop time of up to four operating times that you would like to attend. Please specify at least one, and up to four. For more detailed requests, please email field-day@ccares.net
What day for period 1 *
Time that you plan to start? *
Time
:
Time that you plan to stop? *
Time
:
What day for period 2
Time that you plan to start?
Time
:
Time that you plan to stop?
Time
:
What day for period 3
Time that you plan to start?
Time
:
Time that you plan to stop?
Time
:
What day for period 4
Time that you plan to start?
Time
:
Time that you plan to stop?
Time
:
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
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