Kentucky ARES Public Service Report

Kentucky ARES Public Service Report

To submit your monthly report, please complete the following form. It will be transmitted to the Section Manager. A copy of this form will be returned to you. This form is based upon ARRL Form FSD-157. If the text you are typing is longer than the form field, don't worry as the text will scroll as you type.

Nature of Activity:

	Communications Emergency. Amateurs supplied communications required to replace or supplement normal communications means.
	Alert. Amateurs were deployed for emergency communications, but emergency situation did not develop.
	Special exercise. Amateurs supplied communications for a parade, race, etc.
	Test or drill. A training activity in which amateurs participated.

Please give a brief description of the activity:

Places or areas involved:

Number of Amateur Operators Participating:

Event Start Date/Time:		Durations (Hours):
Event End Date/Time:		Total Manhours:

Number of Repeaters Used:

Estimated manpower cost:	$ (Total Manhours times $10 per hour)
Estimated cost of equipment used:	$
Total estimated cost of service:	$ (Total of two previous totals)

Nets and/or frequencies used (including repeater call signs):

Number of Messages Handled:

Agencies/Organizations Receiving Support:

Please List Callsigns of Amateurs Who Were Key Participants:

Comments:

Name of Organization Performing Service:

Location of Organization:

By submitting this form, I attest the information provided above is complete and true

Name:		Callsign:
Address:		Email:

ARRL Appointments:

Phone Number: