PAWG MEMBER COMMUNICATIONS AVAILABILITY DATA

Your Name

   CAP ID  Unit

   Radio Call, CAP  Radio Call, Ham

   Radio Call, Other Closest Airport

   Email Address     24 Hour Contact Phone

   NEXTEL Direct Connect

   Are you willing to deploy overnight if possible to the field? Yes No

CAPABILITIES AND EQUIPMENT ASSESSMENT

DO YOU HAVE THE FOLLOWING EQUIPMENT OR CAPABILITIES AT YOUR DISPOSAL? CHECK ALL THAT APPLY.

HF Radio VHF Radio AM Aircraft 800 State Radio UHF ISR Radio HAM Radio

4X4 Vehicle Internet Access Generator / Emergency Power

AVAILABILITY STATUS

Please detail your status for deployment over the next 72 hours. Be specific, list any times if applicable that you are not available either for work or other commitments.