Exit this survey

1.

* 1. Name:

* 2. E-Mail:

* 3. UIN:

* 4. Cell Number (Use format: 555-555-5555)

* 5. Emergency contact info: name AND number:

* 6. Position Applying For (Check All that Apply)

7. If you selected "Driver" as a choice, how many people can you accommodate (including yourself)? Does your car have a hitch assembly?

8. If you have your HAM call sign, please enter it here.

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