Volusia ARES Application

Fill in the form below to submit your application.

Your Name: *

Street Address: *

City/ST/Zip: *

Home Phone: *

Alt. Phone: *

E-Mail Address: *

Call Sign: *

License Class: *

Amateur Radio Capabilities
Check all that apply.

CW

HF Fixed/Mobile
Fixed Mobile

VHF/UHF Analog Fixed/Mobile/Portable
Fixed Mobile Portable

VHF/UHF D-Star Fixed/Mobile/Portable
Fixed Mobile Portable

Packet/Winlink2K
Packet Winlink2K

Volunteer Interests
Check all that apply.

Non-Emergency Neighborhood HamWatch Skywarn
Volusia County Emergency Operations Center Other

If Other, Please specify:

Special Skills or Past Experience (No previous experience required)
Summarize skills and past experience related to amateur radio, ARES, emergency communications, etc.

Volusia ARES Code of Conduct
Volusia ARES members:

will be respectful to all ARES members and officials
will be law-abiding, maintain a sense of professionalism, and not bring the organization into disrepute
will participate in meetings, nets, simulated emergency test (SET) exercises, and undergo the training necessary to fulfill their volunteer commitments
will treat served agencies with courtesy
will avoid misrepresenting themselves as agents or employees of a served agency
are individuals who have NOT been convicted of a felony

Agreement and Signature
By submitting this application, I affirm that the facts set forth in it are true and complete to the best of my knowledge, and that I will abide by the code of conduct.
I understand that if I am accepted as a volunteer, any false statements, omissions, other misrepresentations made by me on this application, or failure to abide by the code of conduct may result in my immediate dismissal.

Electronic Signature: *