ESCAMBIA COUNTY AMATEUR RADIO EMERGENCY COMMUNITY REGISTRATION
Copy the form below into an e-mail, fill out the information and send to:
Jim Burrows N4LRM

Mike Jacobus N4DIA

and - ESCAMBIA COUNTY ARES



PDF SIGN UP

WORD SIGN UP

If you have a problem with either file, you can cut and paste the below form.


Escambia County, Florida ARES/AREC Registration Form
There is a status field below is to specify your intended involvement will be in ARES.
Active - participating in exercises, incidents, and hurricanes
Limited - checks in local ARES net, not as active otherwise
Reserve - not active anymore, but leave me on the list for the future.
To register or update your information, please send an e-mail with the below information to EscambiaCountyARES@live.com Callsign
License Class
Address (street, city, state, zip)
E-mail
Status (Active, Limited, Reserve)
Availability (anytime, nights, weekends, etc) Home phone
Cell phone
Work phone (please include ext.)
Escambia County EOC ID Badge (Y/N)
E-Team Login (Y/N)
Do you have emergency power at home? (Y/N)
Do you own a portable generator (Y/N)
Home station (Y/N) Mobile (Y/N) Portable Y/N
2 meters
440 UHF
HF
APRS
D-STAR
Other digital modes: ______________________________________________________
FEMA ICS courses Y/N ARRL Emergency Communications Courses (optional) Y/N
ICS100 old level 1
ICS200 old level 2
ICS700 old level 3
ICS800
ICS300 (optional) New course - EC001 Introduction to Emergency Communications

ICS400 (optional)
Other Training:
Remarks: