RCARES

Membership Application

Complete application and send it to rcares@wiktel.com

New Application?

If Yes, Do you want to be contacted by your Emergency Coordinator?

Call Sign:

Name:

Town:

Home #:

Work #:

Cell #:

Pager #:

License Class:

Age (optional):

Red Cross Certifications

Intro to Disaster Services:

Mass Care:

Shelter Simulation:

Shelter Operations:

Damage Assessment:

Other:

ARRL  Certifications / Appointments

EC-001:

EC-002:

EC-003:

AREC Mentor:

AREC Examiner:

Antenna EC-004:

Digital EC-005:

RFI: EC-006:

Satellites EC-007:

Repeaters EC-008:

VEC:

Other:

Other Professional Skills / Experience / Training

Doctor:

Nurse:

EMT:

CPR

Pilot:

Radio Tech:

Fireman:

Policeman:

MARS Call Sign:

Packet/APRS/PSK31:

Search & Rescue:

Skywarn:

Teacher:

Web Design:

NTS Traffic:

Other:

Home Station Equipment / Capabilities

80 Meters:

40 Meters:

6 Meters:

2 Meters:

70 CM:

Packet:

APRS:

PSK31:

Pactor:

RTTY:

Generator:

Tower:

FAX:

HF Linear:

ATV:

Portable Equipment / Capabilities

HF Radio:

Repeater:

Generator:

Solar Panel:

Tower:

Laptop:

Packet Node:

GPS:

APRS Tracker:

2/440 Mobile:

2/440 HT:

2M Mobile:

2M HT

HF Mobile:

6M Mobile:

24hr Kit:

72hr Kit:

RV:

Comm Van:

All Terrain:

4x4 Vehicle:

Snowmobile:

Other:

Interests / How you can help!

Reporting local ARES news:

Rapid Emergency Team:

AREC Mentor / Instructor:

Net Control:

ARES Leadership:

Other:

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