ARES Registration Form
Instructions: Fill in the form as best as you can. All information collected on this form will be used for Indiana Section ARES purposes only.
* Required
Name
*
Your answer
Callsign
*
Your answer
Address (Number and Street)
*
Your answer
City
*
Your answer
State
*
Your answer
Zipcode
*
Your answer
County of Residence
*
Your answer
County of Employment
Your answer
Email Address
*
If you use your ARRL reflector e-mail address then you may not get a confirmation e-mail for your submission.
Your answer
Home Phone (123-456-7890)
Your answer
Cell Phone (123-456-7890)
Your answer
Work Phone (123-456-7890)
Your answer
Please indicate your current license class
*
Technician
General
Advanced
Amateur Extra
Are you an ARRL member?
ARRL membership is NOT a requirement to register as an ARES volunteer.
Yes
No
Clear selection
Comments
Your answer
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