Coordination Request

Coordination Request Form
Which frequency band are you applying for?
Which frequency band are you applying for?
Check all of the modes that are enabled on the repeater
Input the repeater's transmitter frequency.
Please select the repeater transmitter CTCSS/DCS code.
Select which standard offset is used. If non-standard, enter the uplink freq. below
Select the repeater receiver access CTCSS/DCS code.
Is this repeater Open to the public?
Would you like this information published on our website?
Please check all of the features that apply.
Height of the antenna centerline above ground. (Numbers only)
Enter as decimal degrees. Example: 39.34532
Enter as decimal degrees. Example: -97.26456
Enter as decimal degrees. Example: 39.34532
Enter as decimal degrees. Example: -97.26456
Please include a brief description of the items to be updated.
By checking this box you are surrendering this coordination, and understand that the frequency or frequencies are immediately returned to the pool and available for re-assignment
I certify that I am the custodian of record and that I have authorization to submit changes to this coordination.