AIS Programming Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Information for programming AIS transponder with vessel-specific information

Email *

Vessel Owner Name: *

Vessel Make/ Model: *

Vessel Length Overall: *

Vessel Name: *

Call Sign:

MMSI Number: *

Vessel Type: *

Please provide the following dimensions (approximate) of where the GPS receiver will be mounted. For most fiberglass or wood boats, the internal GPS receiver can be used (provide AIS unit location's dimensions here). For carbon boats, an external GPS receiver is required (provide external GPS receiver dimensions here).

A - distance from bow (feet):

B - distance from stern (feet):

C - distance from port max beam (feet):

D - distance from starboard max beam (feet):

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Farallon Electronics.

Does this form look suspicious? Report

Forms