ukrepeaters e2-ONLINE FORM

RSGB - Working for the future of Amateur Radio

ukrepeaters

e2 ON-LINE APPLICATION FOR PACKET NODE OR MAILBOX PORT

All questions should be completed, but the form will not send unless fields denoted * are completed.
On submission the form goes to the Data Manager who will process your application, and who will contact you in due course.

If you have (or have been given) a security access code you can click here to access your application to allow corrections during the vetting stages only.
Your ETCC regional member will be able to advise.

Section 1 - The Applicant

Keeper First Name:		* Last Name: * Callsign: *
Address:

Town/County:		Postcode:
Phone Numbers		Landline: Mobile:
E-mail address:		*
Applicant Packet BBS:
Web address:

Section 2 - Basic Details

Callsign Requested:		Reason: *
Type:		*
Use:		*

Section 3 - The Site

Describe Site:		km of (town)
NGR		* or Irish Grid (NB: Minimum 3+3 digits, for example TQ123987)
WGS84:		Latitude Longitude Use decimal format, for example 55.123456, -2.987654 (ensure West of Greenwich is "-")
GPS accurate:		yes no IARU Locator:
Site Address:		different (enter below) same as applicant (now goto Base of mast)
Site Name/Address:

Town/County:
Site Postcode
Base of mast above sea level		Metres Note this will be equivalent to pavement/field level NOT roof level.
Antenna Height above ground level		Metres
Mast Owner:
Is site shared?:		Yes No
If Yes, list:

Section 4 - Technical

EQUIPMENT DETAILS:	Port detail
Make & Model of TX:
Make & Model of RX:
Packet Baud Rate:
ANTENNA DETAILS:
Type of Antenna:
Gain of Antenna:	dBd
Direction of max.radiation:	deg E of N
Polarisation:	Vertical or Horizontal
TX POWER DETAILS:
Peak Power fed to antenna (PX):	dBW
Peak Effective Radiated Power (PXe):	dBW
Port Usage:	User or Link
LINKING TO:
Primary TX Frequency:	MHz
Secondary TX Frequency:	MHz
Primary RX Frequency:	MHz
Secondary RX Frequency:	MHz
NOTE: If your Node/Mailbox has more ports, then please complete another form after you have completed this one.

Section 5 - Closedown Details

Access:

Describe briefly access to the site. This should include how Closedown Ops will get to the site.
*

OnSite:

Describe where equipment is located on site.
*

Disabled:

How is equipment disabled?
*

Repower:

State the person authorised to restore the power.
*

Closedown
Operator 1:
(Keeper)

Closedown Operator 1 must be the Keeper/Applicant
Keeper details have been entered above, but must confirm time taken to effect a closedown request.
Expected time for Keeper to close down station from home:
Estimate of time to close down station if not from home:

Closedown
Operator 2
(cdo#2)

Full name: Callsign:
Landline Number: Mobile:
Home town of cdo#2:
Expected time for cdo#2 to close down station if from home:
Estimated time cdo#2 to close down if not from home:

Closedown
Operator 3
(cdo#3)

Full name: Callsign:
Landline Number: Mobile:
Home town of cdo#3:
Expected time for cdo#3 to close down station if from home:
Estimated time cdo#3 to close down if not from home:

Closedown
Operator 4
(cdo#4)

Full name: Callsign:
Landline Number: Mobile:
Home town of cdo#4:
Expected time for cdo#4 to close down station if from home:
Estimated time cdo#4 to close down if not from home:

Closedown
Operator 5
(cdo#5)

Full name: Callsign:
Landline Number: Mobile:
Home town of cdo#5:
Expected time for cdo#5 to close down station if from home:
Estimated time cdo#5 to close down if not from home:

Section 6 - Declaration

I acknowledge that OFCOM or RSGB may request the node to be closed down at any time, and will comply within 30 minutes of receiving sucvh a request.
I accept responsibility of node manager or mailbox Sysop as outlined in the
"Guide to Repeater and Internet Gateway Licensing"
I will ensure that the station is operated only under the conditions shown in the above document.
I will inform RSGB IMMEDIATELY of any changes to the closedown list.
I hold a current and valid amateur radio licence with callsign as declared in Section 4 above.
The above information is correct to the best of my understanding.
I agree to the above conditions.

Information given in this form is subject to the provisions of the Data Protection Act 1998 and will be used
in accordance with the appropriate entry attributed to the Radio Society of Great Britain and OFCOM.
Please indicate your acceptance:

Security Ident Generator

A feature has been provided to allow you to edit your entry (up until it has completed the vetting stages) and for future renewals.
If you wish to use this feature (it is optional!) please copy the code shown here 37yMFC88 and use it to access your record in the future, or when requested by the ETCC.
Note: Refreshing this page before form submission will change this code and the image verification characters below.

Image Verification
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