EmailMe Form - Amateur Radio License Exam Pre-Registration Form

Personal Contact Information

Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone

### - ### - ####

Email *

Please supply a valid email for us to confirm your registration (this info is private and used solely by WD9BSA VE team).

Testing Information

Test Date *

License Information

Current Callsign

Please indicate your callsign if you're already licensed.

FRN

Administrative number issued to you by the FCC.

Current License Class *

Scout Unit Information

If you're currently a Scout, Scout Parent, or Scout Leader please indicate your Unit information and city. Eg. Pack 550 Thorntown.

As of 09-07-2019 you will be asked if you are a convicted felon in
any state or federal court. Answering yes does not automatically deny
your opportunity to have a amateur radio license issued, but there will
need to be an explanation made by you to the FCC within 14 days of testing. *

Please signify that you've read the above by typing "Agree" or "Understand".