South County Amateur Radio Emergency Service Inquiry Form

Use this form if you:

• want more information about becoming a SCARES member
• want to become a SCARES member
• want to become an Amateur Radio Operator
• are interested in taking code classes

Just fill in this form, submit it, and someone will contact you (allow 5-7 days, just in case). You MUST supply a phone number or email address if you want to be contacted!
If you have any problem submitting this form, please let us know!

Choose all that apply:

I want more information about becoming a SCARES member
I want to become a SCARES member
I want to become an Amateur Radio Operator
I'm interested in taking code classes

Name:

Callsign:

Street Address:

City, State, Zip:

Home phone:

Work phone, extension:

Pager:

Fax:

E-mail address:

Best time to contact you:

Comments:

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