Radio Amateurs of/du Canada

Member Society of the International Amateur Radio Union

Field Organization Report

Note:  All forms are available online for download and local printing at




Please note:     Initial Issuance                                             (check one)






of the appointment as (position),________________________________________________________of


Name ________________________________________________Call Sign _______________



(Street address, city, province and postal code.  SEC/STM SM, please CONFIRM correctness of this information before submitting the form.)





Phone: ______________________________            E-mail: _______________________________



RAC member   Y     N   (Please circle)                       Membership # ____________  Expiry date: ____________

                                                                                                      (from RAC member card or TCA label)

To avoid embarrassment and delay, SEC/STM/SM please ensure that new appointees are current RAC members. 

Confirmed?   Yes ___   (If this is not checked off, the appointment cannot be confirmed by the VPFS.)


Area of responsibility, special duties, or reason for cancellation:







Date  _________________________________     Authorizing signature and call sign  ____________________________________


Return completed form to the Chief Community Services Officer.  This form must be submitted for each and every change in an appointment,

including cancellations.


FSD-211-R (03/07)