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FCC Issued Amateur Callsign:

Email Address:

DMR Radio ID:

(If you plan to use the timeslots on DMR)

Website Password:

(If you wish access to the website)

    I AGREE that this form is only a REQUEST and that I can be denied access to this PRIVATE Repeater.

    I AGREE to comply with ALL Part 97 Rules when utilizing the repeater.


Additional Information:

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