SARC Public Service Event Sign-Up Form

Your contact info:
Mr. Mrs. Ms.
First: Last: Call sign:
E-mail address:
Phone: (area code) (number)

I'm new to this, please pair me up with an experienced ham for this event.

Equipment I can use for this event: (Check all that apply)
HT -             HF      2m      220      440
Mobile rig - HF      2m      220      440
APRS -
ATV -  

Any Additional Notes: