DIGITAL FREQUENCY COORDINATION FORM - INSTRUCTIONS

1. Band:          Check the appropriate Band for this request
2. Output Freq:   TRANSMIT Frequency
3. Input Freq:    RECEIVE Frequency - Leave BLANK if same as TRANSMIT Frequency
4. City:          Name of nearest City or Town to the location of the System
5. Alias:         Node Alias of this System if NETROM is supported.  BLANK for APRS.
6. Callsign:      Callsign including SSID - If SSID is "-0" OMIT
7. Location:      Mountain Top, City, or other location Description
8. Region:        Enter ONLY one of the following:  NW AZ, NC AZ, NE AZ, WC AZ, 
                  C AZ, EC AZ, SW AZ, SC AZ, SE AZ, PHX METRO, TUS METRO
9. County:        County in which the System is located
10. Baud:         Enter ONLY one of the following: 1200, 2400, 4800, 9600, 19200, 38400
11. System Type:  Enter the closest term from the following: SWITCH, DIGI, BBS, NODE, 
                  DX CLUSTER, APRS, DIGITAL RPT, LINK
12. Network Type: Enter ONLY one of the following: NETROM, THENET, BPQ, TCP/IP, X1J, 
                  GATEWAY, PC/TNC, FLEXNET, KANODE, ROSE
13. Software Type:Enter ONLY one of the following: FBB, RLI, MSYS, AA4RE, AK1A, 
                  JNOS (If TNOS enter JNOS)
14. IP Address:   Full numeric internet address for this frequency (Ex: 44.124.34.46)
15. FQDN:         Fully Qualified Domain Name (Ex: heber.ampr.org)
16. Latitude:     Format: DDMM.HH <DEGREES MINUTES . HUNDRETHS OF MINUTES> (EX: 3425.40)
17. Longitude:    Format: DDDMM.HH <DEGREES MINUTES . HUNDRETHS OF MINUTES>(EX: 11034.64)
18. Mountain Top: Enter "Y" or "N" to indicate if the Site is a Mountain Top Site
19. Freq 2:       Additional RF Port on this System
20. Freq2 BAUD:   BAUD Rate of the Freq 2 Port
21. Freq 3:       Additional RF Port on this System
22. Freq3 BAUD:   BAUD Rate of the Freq 3 Port
23. Freq 4:       Additional RF Port on this System
24. Freq4 BAUD:   BAUD Rate of the Freq 4 Port
25. Power Out:    Transmitter Output Power
26. Emission:     Emission Type (Ex: 16F2D = 1200, 20F2D = 9600)
27. Ant Type:     Enter OMNI, BEAM, CORNER, DIPOLE, Etc.
28. Ant Gain:     Antenna Gain in dbi(Isotropic)  NOT  dbd(Dipole)
29. Ant Bearing:  If directional, direction of main lobe(s) in DEGREES
30. Ant Polarity: Enter V, H, LC, RC
31. Ant Height:   Antenna height above Ground Level in FEET
32. Ant Elev:     Antenna height above Mean Sea Level in FEET
    SPONSOR INFORMATION
33. Name:         Name or Initials of Sponsoring Organization.  Enter Owner's Name 
                  if no Sponsor.
34. Callsign:     Sponsor's Callsign
35. Address:      Sponsor's Mailing Address
36. City:         Sponsor's City
37. State:        Sponsor's State
38. Zip:          Sponsor's ZIP Code
39. Phone:        Sponsor's Phone Number with Area Code
40. E-Mail:       Sponsor's E-Mail Address
    OWNER INFORMATION
41. Name:         Owner's Name
42. Callsign:     Owner's Callsign
43. Address:      Owner's Mailing Address
44. City:         Owner's City
45. State:        Owner's State
46. Zip:          Owner's ZIP Code
47. Phone:        Owner's Phone Number with Area Code
48. E-Mail:       Owner's E-Mail Address
    CONTACT INFORMATION
49. Name:         Name of the Point Of Contact for the System
50. Callsign:     Contact's Callsign
51. Address:      Contact's Mailing Address
52. City:         Contact's City
53. State:        Contact's State
54. Zip:          Contact's ZIP Code
55. Phone:        Contact's Phone Number with Area Code
56. E-Mail:       Contact's E-Mail Address
    SITE OWNER INFORMATION
57. Site Owner:   Name of the Individual, Agency, or Company that owns the Site.
                  Limited to 50 Characters MAX.
    SUBMITTER INFORMATION
58. Submitter:    Name of Person submitting this data
59. Callsign:     Submitter's Callsign
60. Phone:        Submitter's Phone
61. E-Mail:       Submitter's E-Mail Address

62. Remarks:      Enter Information such as Major Links, Capabilities, Emergency Power, etc. 
                  If APRS, state type: WIDE5-5, TRACE5-5, etc.
                  Limited to 50 Characters MAX.
63. Signature:    Sign the FORM
64. Date:         Enter the Date Of Submission

Submit completed form, or questions, to: packet@azfreqcoord.org