VE Application
* Required
Are you 18 years old or older?
*
Yes
No
Have you ever been disaccredited by another VEC?
*
Yes
No
Has your license ever been revoked or suspended?
*
Yes
No
Have you ever been convicted of a felony?
*
Yes
No
Do you agree to abide by the rules and regulations governing volunteer examiners as stated in Federal Communications Commission Part 97 -Amateur Radio Service and the LARC VEC policies, procedures and instructions provided to its VE teams?
*
Yes
No
Print name shown on license.
*
Your answer
Call Sign
*
Your answer
License Class
*
Choose
General
Advanced
Extra
Primary Phone#
*
(This is the phone you’ll most frequently answer)
Your answer
Secondary Phone#
Optional
Your answer
Tertiary phone #
Optional
Your answer
Email
*
Your answer
Signature
*
Please enter your full legal name. By signing below you agree are agreeing to the terms set forth, and that all the information provided is true to the best of your knowledge.
Your answer
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