HAM Operators Registration Form

The points marked with red* are compulsory fields.
Operator Details :
1. *Name
2. *Date Of Birth
2a. Age   
3. *District
3. *Address with Pin
4. *Mobile No.
5. Telephone Number
6. Fax
7. *E-mail Id
8. Whats App No
(if different from above mobile no.)
(Your Whats App No. will be added to the State Disaster Communication Network)
9. Qualification
10. Blood Group
Equipment Details :
11. *Number of equipments (HF / VHF / UHF)
Description of HAM equipment (whether HF/ VHF / UHF) * Call Sign * License No. * Validity of License (DD/MM/YY) *
From * To *
Other Details :
16. Details of experience (if any) of Disaster Response Operation
17. *Are you ready to provide your services as HAM operator
for disaster related emergency communication
in the state of MP
18. Please specify, if any support is expected from MP SDMA in HAM equipment operation
19. Related suggestion, if any