Amateur Radio donates thousands of person hours of supplementary public service communications in civil emergencies, official drills and events such as parades and marathons each year. Please complete and return this form. Thank you.

(person-hours times $19/hour)

(handhelds, repeaters, etc.)

(add amounts from lines 10 and 11)

I attest that the information provided above is complete and true to the best of my knowledge.

Add your e-mail if you would like to receive e-mail confirmation that this report was received at Headquarters.