Enter ARES membership application

Connecticut ARRL Section
Amateur Radio Emergency Service (ARES) Member Record

This is a web-based registration form. Your information will be recorded in our ARES membership database.
When finished, click the "Enter Registration" button at the bottom. You should receive a response email shortly.
Thank you for your interest in becoming part of the Connecticut ARES team.

General Registration Information

Check one or more Don't List boxes if you do not wish the information to be printed on any rosters.

Please fill-in your information in the boxes below

Don't
List

Callsign:

(Required)

License
Information:

Amateur License Class:
Expiration Month (MM):		(i.e. 03)
Expiration Day (DD):		(i.e. 12)
Expiration Year (YYYY):		(i.e. 2010)

Name:


First Name	MI	Last Name

Address:

City/State/Zip:

(Required)

Your County:

(Required)

Town Work In:

Home Phone:

Office Phone:

Cell Phone:

Pager Phone:

Other Phone:

Internet E-mail:

Alternate E-mail:

(Required)

Packet E-mail:

Date of Birth:

DOB Month (MM):		(i.e. 02)
DOB Day (DD):		(i.e. 14)
DOB Year (YYYY):		(i.e. 1955)

Password:

(Used by you to keep your record up-to-date) (Required)

Band/Mode Capability Information

Specify Fixed, Mobile, and Portable for each band and mode for which you are equipped and capable:
Band/Mode capability fields should be less than 6 characters i.e. FMP

	160M	80-20M	WARC HF	10M	6M	2M	220	440
CW
SSB
FM
AMTOR
PACTOR
Packet
Other

Emergency Power Information

Check the appropriate boxes for emergency power at your FIXED station. Do not include automobile or alkaline/NiCad batteries for radios included in Mobile/Portable operations in the table above. This is only for home station operation.

	160M	80-20M	WARC HF	10M	6M	2M	220	440
Battery
Generator
Solar
Other

Additional Technical Information

Check the box if Yes otherwise leave blank for No and provide additional information where applicable:

Portable/Mobile/Transport	Yes?	Digital, Weather, ATV, etc	Yes?
If you answered NO to mobile/portable packet above, can you operate a mobile/portable node or digipeater?		Do you have a computer (Dos, Windows, Mac)? Please specify OS:
Do you have a 4-wheel drive vehicle? If YES, then specify:		Do you have a computer modem for landline phone?
Do you have a hi-capacity vehicle? If YES, then specify:		Do you have expertise in Packet/Digital Modes? If YES, then specify:
Do you have a snowmobile?		Do you have Digital weather? WEFAX? Emwin? If YES, then specify:
Other off-road / All-Terrain Vehicles? If YES, then specify:		Do you have an EMWIN/WeatherNode setup?
Do you have a magnetic mount antenna? If YES, then specify:		Do you have a Weather Radio with Alert? With SAME/EAS upgrade?
Do you have a 2m/440 radio with cross-band/repeat AND do you know how to use it?		Does your TNC have other modes not listed? If YES, then specify:
Do you have a portable mast? If YES, then specify height (feet): Please specify any beams you may have?		Is your Packet station more than AX-25 PBBS/TNC? If YES, then specify (Dual-HF, IP, APRS): BBS Type: Weather Node:
Do you have a portable gas generator? If YES, then specify KW Rating:		Do you have any exotic modes: Satellite, ATV, etc.? If YES, then specify:

Activation Information

Check the box if Yes otherwise leave blank for No and provide additional information at the bottom of the form if needed. An answer of No is OK, since we need to know who is and who is not available for those emergencies that are not conveniently on long weekends but aren't quite severe enough to close all businesses.

	Yes?		Yes?
Are you available 24 hours a day? (E.g., will you respond to emergencies after midnight?)		Are you interested and able to help in activation notifications? (Requires high-availability and either lots of phone-dialing or alpha-pager software.)
Are you available for real emergencies during business hours (0800 - 1700 M-F)?		Are you willing to work routine (non-emergency) public service events?

Organizational Information

Check the box if Yes otherwise leave blank for No and provide additional information where applicable:

	Yes?		Yes?
Do you want to receive ARES roster updates and other messages at your Internet address?		Have you had previous ARES/RACES appointments? If YES, then position(s): If YES, then where:
Do you want to be considered for ARES net control? If YES, do you have NCS experience (Y/N)?		Are you actively involved in NTS? If YES, then ORS, NM, NCS, Other?
Are you willing to help with recruiting for ARES in your town, community or club? If YES, then specify:		Would you like information on the National Traffic System (NTS) and becoming an Official Relay Station?
Are you actively involved in Skywarn? If YES, then Net Coordinator, Net Control, Spotter, Other?		Do you hold any other ARRL Field Position? If YES, then specify:
Have you received Skywarn training? If YES, then when: If YES, then where:		Are you RACES enrolled and in good standing? If YES, which town: If YES, what position:
If you have not received Skywarn training, would you like information on Skywarn?		Do you have relationships with other served agencies or radio auxiliaries that might conflict or would make you a natural Liaison? Examples: RACES, MARS, CAP, CG Auxilary, American RedCross, Salvation Army. Possible Conflicts (Yes)? Which Agencies: Possible Liaisons (Yes)? Which Agencies:

	Yes?
Do you have prior Emergency Communications experience & training such that you qualify for OES? If YES, please explain below. Qualified experience might include RACES, Skywarn, Non-emergency Public Service Events, and Red Cross. Please note that OES appointments require ARRL membership.

Additional Information and Comments

Provide any additional information you feel will be helpful to ARES. Include such things as special training (emergency management, incident-command, first aid/medical, search and rescue, computer experience, electronics tech, public relations, EMT, fire-fighter, haz-mat), other communications or public service memberships (notification nets, Red Cross, etc.), or any special equipment you own and can make available to ARES. Please enter the training and equipment details when you login after creating this record. Please use the space below: