Kitsap County ARES Membership Registration

First Name

Last Name

Mailing Address

Mailing City State Zip

Ham Radio Call Sign

Phone Number

Operator Class

Email

GMRS Call Sign

SkyWarn Number

Micro Island you live in

Micro Island you work in

ARRL Certs

ARRL EC-001 ARRL EC-016 ARRL PR-101

Will you volunteer in locations as requested by our served agencies?

Yes No

Do you have UHF/VHF Mobile?

Yes No

Do you have UHF/VHF Portable?

Yes No

Do you have NBEMS Training?

Yes No

Do you have WinLink Training?

Yes No

FEMA IS-100

Yes No

FEMA IS-200

Yes No

FEMA IS-700

Yes No

FEMA IS-800

Yes No

Amateur Radio Emergency Service®