Brandon Amateur Radio Club Inc.
EST - 1948
z
Manitoba Canada
VE4QD VE4BDN VE4TED VE4HS VE4CTY
25 Queens Crescent · Brandon · Manitoba · Canada · R7B 1G1

· AMATEUR RADIO EMERGENCY SERVICES ·
EMERGENCY RADIO OPERATORS ARE NEEDED
Please complete our Online ARES Information Form.     Fields marked ( * ) are required.
BRANDON AMATEUR RADIO CLUB INC.
25 Queens Crescent · Brandon · Manitoba · Canada · R7B 1G1

ARES INFORMATION
* CALLSIGN : * EMAIL :  * DATE :
* FIRST NAME :   * LAST NAME :
* PHONE : -    WORK : -  EXT :     CELL : -
* STREET ADDRESS :   APT# :   PO BOX :
* CITY/TOWN :  * PROVINCE :  * POSTAL CODE :
* OCCUPATION :
* POSSESS A SAFETY VEST/ID CARD :   YES NO
  VHF HT :       YES NO VHF MOBILE :      YES NO
  VHF BASE :     YES NO VHF ANTENNA :   YES NO
  HF BASE :       YES : NO HF BASE ANTENNA : YES : NO
  HF MOBILE :   YES NO HF MOBILE ANTENNA : YES NO
  UHF BASE :    YES NO UHF MOBILE :
   GENERATOR : YES NO GENERATOR OUTPUT :
  OPERATING BANDS :
  PLEASE LIST ANY OTHER EQUIPMENT OR QUALIFICATIONS THAT YOU MAY HAVE.
  MISC :
  NOTES :
Please be sure to complete all required fields before you submit your form.
   Once your form has been completed send it along to us by using one of the two options below.
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Brandon Amateur Radio Club Inc Copyright © 2006- 2008 TCA Barrett VA4KLG