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2015 North Shore Century Ham Radio Team
NSC is Sunday, September 20, 2015. Please fill out form below to register
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* Indicates required question
First name
*
Your answer
Last Name
*
Your answer
Email
*
Your answer
Call Sign
*
Your answer
Contact phone
*
xxx-xxx-xxxx
Your answer
Address
Your answer
City
Your answer
State
Your answer
Zip Code
xxxxx
Your answer
Preferred assignment
Every attempt will be made to schedule you in your preferred assignment.
Ham SAG AM (6 a.m. noon)
Ham SAG PM (11 - 4 p.m.)
Ham SAG all day
Base Aid Station
SAG car only (need radio/APRS equipment)
Ride with Bike Club SAG car
Forward command
Clear selection
Last years's assignment
Your answer
T-Shirt Style
Short Sleeve
Long Sleeve
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T-Shirt Size
Small
Medium
Large
X Large
XX Large
Other
None
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Additional comments.
Please tell us anything that relates to this event that can help us schedule our team
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Emergency contact
Name of some person we can contact on your behalf
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Contact number
xxx-xxx-xxxx format please
Your answer
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