BERKELEY COUNTY ARES/RACES MEMBERSHIP APPLICATION

Berkeley County ARES/RACES is seeking volunteers to serve our County. Fill in the information below to apply for membership.

First Name

MI

Last Name

Address 1

Address 2

City

State

Postal Code

Phone

Email Address

Best Time to Contact

Have you previously been a member of any ARES or RACES group (if yes give details)?

No

Yes

What is your Call Sign (none if not licensed)?

What is your License Class (if applicable)?

Where did you find out about Berkeley County ARES/RACES?

What days of the week are you consistently available (check all that apply)?

What FEMA, ARRL or other courses have you taken (check all that apply)?

What areas of activity would you be interested in (check all that apply)?

Does your home station have emergency power available (if Yes, please describe)?

No

Yes

Do you have a mobile station (if Yes, describe it's capabilities)?

No

Yes

What Visual or Digital Modes can you operate (check all that apply)?

Do you have any medical problems that would limit your abilities to perform your duties?

Yes

No

What Bands can you operate on (check all that apply)?

Comments/Additional Information

Indicates Response Required