2017 MS 150 Best Dam Bike Tour
Amateur Radio Volunteer Signup Form
Saturday, August 5th & Sunday August 6th

HAM Callsign 

This is my first time volunteering for the MS 150       This is my year of volunteering

Please Check Days available:

Saturday & Sunday Saturday Only Sunday Only

Please send me information on how I can raise pledges (and earn prizes) as an MS 150 Volunteer

Tell us about yourself!

I have a connection to MS

If yes how?

If you have any physical limitations to be considered (must sit, can't lift, use a wheelchair, get fatigued, pregnant, etc.)
(If yes, please describe)

If you have any medical training, please describe


Emergency Contact Information

Emergency Contact Not on the Ride
 

Emergency Contact On the Ride       Phone xxx-xxx-xxxx


Previous Positions worked (Check all that apply)

Shadow
Sag Wagon
Rest Stop
Medical
Net Control
Motorcycle
Ambulance
Utility

In order that we might assign you to the best possible position, we would like to know what kind of equipment you might be using. Please check all that appy below:

Dual Band Mobile
440 Mobile
2 Meter Mobile
Mag Mount Antenna

Handheld Dual Band
Handheld 440
Handheld 2 Meter

APRS Station
CB
OTHER

I agree that the above information is corrrect. Must check this box before you can submit.
Please only hit Send Form Once and WAIT as it may take a minute or two to process your information.