Jacksonville Laurel Registration
FIRST_NAME *
First name as appears on your ID
Your answer
MIDDLE_INITIAL
Middle Initial as appears on your ID
Your answer
LAST_NAME *
Last name as appears on your ID
Your answer
NAME_SUFFIX
Suffix (Sr, Jr, etc)
Your answer
Address
STREET_ADDRESS *
Your answer
CITY *
Your answer
STATE *
ZIP_CODE *
Your answer
Contact Information
This is important as it allows us to contact you if there are any errors and to correct them before your results are sent to the FCC, which would otherwise cause your application to be rejected
TELEPHONE
Your answer
E_MAIL
Your answer
FCC Registration Number
If you have an Amateur or GMRS Licence, you can find it on your license or at http://wireless2.fcc.gov/UlsApp/UlsSearch/searchLicense.jsp

If you don't have an FRN, you can create one at https://apps.fcc.gov/coresWeb/regEntityType.do

YOU MUST PROVIDE AN FRN PRIOR TO THE TEST

FRN
FCC Registration Number
Your answer
Current License
CALL_SIGN
Current AMATEUR RADIO Call Sign(if any)
Your answer
LICENSE_CLASS
CURRENT CLASS(if any): (N)ovice, (T)echnician, (G)eneral, (A)dvanced, or (E)xtra
EXPIRATION_DATE
Expiration Date
MM
/
DD
/
YYYY
I want to get...
NEW_LICENSE
You don't have a license...yet
UPGRADE_LICENSE
You want to upgrade your license and enjoy more privileges
RENEW_LICENSE
You want to renew your license. It expires within 90 days or you are within the 2 year grace period.
CHANGE_ADDRESS
The address above is different than the FCC database
CHANGE_NAME
You want to update your name in the FCC database
CHANGE_CALL
You want to change your call sign systematically
Felony Conviction
FELONY_CONVICTION *
Have you ever been convicted of a felony in any state or federal court?
Other Information
Test Date
Accommodation
Do you need any accommodations for the exam?
Pending_Applications
Do you have any pending applications, such as Vanity or Upgrades?
How did you find about this test?
Would you like local clubs to email you about upcoming meetings and events?
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