Kentucky ARES District 4 Station Appointment Application

Kentucky ARES District 4 Station Appointment Application:
Thank you for volunteering to serve as a coordinator for Amateur Radio Emergency Service. This form will be received by the DEC of your district and ASEC of your region.

Before applying for a Kentucky ARES appointment, please read the job description of the position you are seeking.
ADEC	AEC	ASEC	DEC	EC	OES

By submitting this form, you attest that all information is complete and accurate.

Name:*		Email:*
Callsign:		License Class:
Address:		City/St/Zip:
County:
Day Phone:		Evening Phone:
Cell Phone:		ARRL Member:	Yes No

Amateur Radio Organizations You Are A Member Of:

Please list the bands you can work: (Check all that apply)
Data:	HF VHF/UHF 1.2 GHz
Packet:	HF VHF/UHF 1.2 GHz
CW:	HF VHF/UHF 1.2 GHz
SSB	HF VHF/UHF 1.2 GHz
FM	HF VHF/UHF 1.2 GHz
Other:	HF VHF/UHF 1.2 GHz
Present ARRL Appointments:

Past ARRL Appointments:

Please describe your qualifications: (experience, and/or interests)