Coordination Request Form
Sponsor Initials :
Primary trustee call :
Sec. Trustee call :
ARRL Designation :
Public access?
Powered from?
Tone required?
Remote base?
Linked system?
Portable system?
Wide area coverage?
public system
private system
Municipal grid
Solar
Wind
Battery
Emergency
Purpose :
Repeater
PNT to PNT
Packet
Video
Control
Aux Link
Call sign Broadcast :
TX Frequency (MHz) :
RX Frequency (MHz):
Mode :
Tone :
Power (W) :
Gain (dB):
Beam Heading :
Beam Width :
Elevation (ft) :
Service Area :
Linked system Name :
City :
Email Address :
Site Name :
Latitude :
°
'
"
Longitude :
°
'
"
Known Site :
Angel Pk
Angel's Roost
Beckwurth Pk
Bunker
Cave Mt.
Conway Pk
Corey Pk
Eagle Ridge
Ely Mt.
Fox Mt.
Genoa Pk
Grindstone Mt.
Highland Pk
Independance Pk
Jacks Pk.
Kimberly Pk
Lamoille
Lewis Mt.
Leviathan Pk
Lobdell Pk
McClellan Pk
Mazourka Pk
Moleen Pk
Montezuma Pk
Ophir Hill
Pequop Mt.
Peavine Mt.
Pond Pk
Porcupine Pk
Potosi Mt.
Prospect Pk
Rose Mt.
Red Pk
Shaffer Mt.
Silver Pk
Slide Mt.
Spruce Mt.
Squaw Pk
Toulon Pk
Sweetwater Pk
Virginia Pk
Ward Pk
Warm Springs Pk
Winnamucca
Victoria Pk
Notes:
Account password :
Coordination Request Form
Coordination Request Form