SouthBears Disaster Relief Communications

Station Profile

&

Volunteer Information Form

It will be necessary to log onto the Yahoo User Groups to view the full roster.

 The Roster is in the file section named SouthBears Roster.pdf

To log in, click here

If you don't need to make corrections then there is NO NEED to submit an update. 

Please complete the information requested below 

First Name  Last Name

Amateur Call  License Class

Street Address

City     State  Zip

Home Phone   Cell Phone

Work Phone     Pager    

Fax   E-Mail Address

Please select your responder preference inside this box

Please confirm your responder preference by typing your preference in the box below

Whom to notify in case of emergency

(The system will not accept "same as above" responses) 

Name

Address

City   State Zip

Home Phone   Work Phone

Relationship

Amateur Radio Capabilities

(Check all that apply, a checked box means you have that capability)

HF Mobile and/or Portable Ability

HF Base/Home Operation

HF Phone Patch Ability

VHF HT (2 meters)

VHF Mobile (2 meters)

VHF Base/Home Operation

VHF Mobile APRS Ability

Dual Band HT (2 meters/440)

Dual Band Mobile (2 meters/440)

Dual Band Base/Home Operation (2 meters/440)

In the block below please provide any other amateur radio capabilities you might have that would be beneficial to use in disaster relief (Packet, PSK31, CW, etc)

Disaster Relief Training

(Check all that apply, a checked box means you have had that training)

Phase I Communications

Phase II Communications

Unit Director Training

If you have any other information that you would like to provide concerning your ability to serve as a communications volunteer please do so in the space provided below. (Additional training, special skills, etc.)

Date Submitted Month/Day/Year

After you complete filling in your information please review for accuracy and then click the "SUBMIT" Button

Page last edited 02/10/2008

When properly submitted the above information will be automatically e-mailed to those who maintain the Southern Baptist Disaster Relief Communications Data Base.  Thanks for helping us keep this information current.