EAS RMT

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1. ENTER YOUR STATION CALL SIGN

ENTER YOUR STATION CALL SIGN

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2. PLEASE ENTER YOUR ZIP CODE

PLEASE ENTER YOUR ZIP CODE

3. DID YOUR STATION RECEIVE THE REQUIRED MONTHLY TEST?

DID YOUR STATION RECEIVE THE REQUIRED MONTHLY TEST?   YES NO

4. ON WHAT MONITORING ASSIGNMENT DID YOUR STATION RECEIVE THE RMT? (IF RECEIVED ON MULTIPLE MONITORS, PLEASE LIST ALL THAT APPLY)

ON WHAT MONITORING ASSIGNMENT DID YOUR STATION RECEIVE THE RMT? (IF RECEIVED ON MULTIPLE MONITORS, PLEASE LIST ALL THAT APPLY)   MONITORING ASSIGNMENT 1
MONITORING ASSIGNMENT 2
MONITORING ASSIGNMENT 3
MONITORING ASSIGNMENT 4
MONITORING ASSIGNMENT 5
MONITORING ASSIGNMENT 6

5. ON WHAT DATE AND TIME WAS THE RMT RECEIVED?

	MM		DD		YYYY		HH		MM	AM/PM
DATE/TIME RECEIVED	ON WHAT DATE AND TIME WAS THE RMT RECEIVED?   DATE/TIME RECEIVED   Month	/	Day	/	Year		Hour	:	Minute	-AMPM AM or PM
DATE/TIME REBROADCAST	DATE/TIME REBROADCAST   Month	/	Day	/	Year		Hour	:	Minute	-AMPM AM or PM

6. WAS THE AUDIBLE PORTION OF THE TEST CLEAR AND UNDERSTANDABLE?

WAS THE AUDIBLE PORTION OF THE TEST CLEAR AND UNDERSTANDABLE?

7. WHAT BRAND/MANUFACTURER ENCODER/DECODER DOES YOUR STATION USE?

WHAT BRAND/MANUFACTURER ENCODER/DECODER DOES YOUR STATION USE?   SAGE TFT TRILITHIC DASDEC GORMAN-REDLICH HOLLYANNE

Other (please specify)

8. WHAT IS THE MODEL NUMBER AND FIRMWARE VERSION OF THE ENCODER/DECODER YOU HAVE?

WHAT IS THE MODEL NUMBER AND FIRMWARE VERSION OF THE ENCODER/DECODER YOU HAVE?

9. Please provide your contact information. The information will only be provided to other EAS participants and will not be shared with any other parties.

Please provide your contact information. The information will only be provided to other EAS participants and will not be shared with any other parties.   Name:
Email Address:
Phone Number:

10. COMMENTS/FEEDBACK:

COMMENTS/FEEDBACK: