Radio Amateurs of/du Canada

"We're ALL about Amateur Radio!"  "Tous ensemble pour la radioamateur!"

Member Society of the International Amateur Radio Union

Field Services Organization

Public Service Activity Report 

 

About This Form:                                                                                                                                                            Return to RAC ARES Pages

 

Each year Amateur Radio donates thousands of person-hours of supplementary public service communications during real emergencies, through simulated emergency tests and at events such as parades and marathons.  Participation in these kinds of events shows Amateur Radio at its best.  It is critically important that RAC bring documentation of this public service work to the attention of Industry Canada and other public officials. ALL such events, including those not involving RAC members or Services, should be reported. The information you provide on the form below will be an important addition to the records. Please complete and return this form to RAC Headquarters, 720 Belfast Rd, Suite 217, Ottawa, ON K1G 0Z5.  Mark it to the attention of VP Field Services.  Send a copy to your RAC Section Manager as well.

 

 

1.       Nature of the activity (check one):

 

                         Text Box:  
Communications Emergency. Radio Amateurs supplied communications required to replace or supplement normal communications means.

              Text Box:  
           Alert. Radio Amateurs were deployed for emergency communications, but emergency situation did not develop.

 

   Text Box:  
         Special event. Radio Amateurs supplied communications for a parade, race, marathon etc.

                

 

  Text Box:  
          Test or drill. A training activity in which Radio Amateurs participated.

 

 

2.       Brief description of activity: ___________________________________________________________

 

3.       Places or areas involved:______________________________________________________________

 

4.       Number of Radio Amateurs participating: ____________

 

5.       Event start date/time: _______________________      6. Event end date/time:___________________

 

  1. Duration of event (hours): ___________________          8. Total person-hours:____________________

 

  1. Number of repeaters used: ___________________

 

 

 

 

 

Text Box:       10.   Estimated person-power cost:                            $_____________  (person-hours X $10.00/hour)
 
     11.  Estimated original cost of equipment used:           $_____________  (hand-helds, repeaters, etc.)
 
     12.  Total estimated cost of service:                           $_____________  (add amounts from lines 10 and 11)

 

 

 

 
 

13.  Nets and/or frequencies used (including repeater call sign):

__________________________________________________________________________________________________________________________________________________________________________________________

 

14.  Number of messages handled: __________________

 

15.  Names of agencies receiving communications support:

____________________________________________________________________________________________________________________________________________________________________________

 

16.  Please list call signs of Radio Amateurs who were major participants:

 

 

17.  Other comments:

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Please attach photos of Radio Amateurs in action, newspaper clippings or any other supporting data.

 

Location of your organization (municipality): __________________________________Province: ___________

 

Your name: _______________________________________________Call sign: ________________________

 

Address: ________________________________________________________________Postal Code_________

 

RAC appointment, if any: ________________________________E-mail: _____________________________

 

Telephone: Res: (____)___________________________Other:(____)_________________________________

 

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

 

Signature: _________________________________________________Date: ___________________________

 

FSD-157-R   (Jul/06)