ARRL Appointment Application 
District Emergency Coordinator

SEC: Frank Wolfe, NM7R

 Western Washington

Date:   Call: 

First name:    Last name: 

Address:    County:

City:    State:  Zip 

 Email address:

Home phone    Business Phone 

Place of business    License class 

Age    ARRL Membership expiration date 

List names of Amateur Radio clubs of which you are a member:

Are you active on: 2-meter FM? Yes No
                               Packet radio? Yes No

List your present emergency equipment:

Present ARRL appointments 

Former ARRL appointments 

Why do you want to become a District Emergency Coordinator?

 I have read the job description for this position and agree to perform the duties to the best of my ability. I agree to maintain current League membership, and report my station activity on a regular basis.YES No


  FSD-156 (1-93)

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