NCVEC QUICK-FORM 605 APPLICATION FOR AMATEUR …

1 NCVEC QUICK-FORM 605 APPLICATION FORAMATEUR operator / primary station license SECTION 1 - TO BE COMPLETED BY APPLICANTPRINT LAST NAME SUFFIX (Jr., Sr.)FI RST NAMEINITIALSTATION CALL SIGN (IF ANY)MAILING ADDRESS (Number and Street or Box)SOCIAL SECURITY NUMBER (SSN) or (FRN) FCC FEDERALREGISTRATION NUMBERCITYSTATE CODE ZI P CODE (5 or 9 Numbers)E-MAIL ADDRESS (OPTIONAL)DAYTIME TELEPHONE NUMBER (Include Area Code) OPTIONAL FAX NUMBER (Include Area Code) OPTIONALENTITY NAME (IF CLUB, MILITARY RECREATION, RACES) I HEREBY APPLY FOR (Make an X in the appropriate box(es))EXAMINATIONfor a new license gran t CHANGEmy mailing address to above addressEXAMINATIONfo rupgra de of my license clas sCHANGEmy station call sign systematicallyCHANGE myname on my license to my new nam e Applicant s Initials: _____ Former Name: _____RENEWALof my license grant .I certif y th at: I waive any claim to the use of any particular frequency regardless of prior use by license or otherwise; All statements and at tachments are true, complete and correct to the best of my knowledge and belief and are made in good fa ith ; I am not a representative of a foreign government; I am not subject to a denial of Federal benefi ts pursuant to Section 5301of the Anti-Drug Abuse Act of 1988, 21 862 ; The construction of my station will NO T be an action which is likely to have a significant environmental effect (See 47 CFR Sect ion s 9 and Section (a)).

2 I have read and WIL L COMPLY with Section (c) of the Commission s Rules regarding RADIOFREQUENCY (RF) RADI ATION SAFETY andth e AMATEUR service section of OST/OET Bulletin Number 65 .Signature of applicant (Do not print, type, or stamp. Must match applicant s name above.) (Clubs: 2 different individuals must sign ) X _____Date Signed: _____ SECTION 2 - TO BE COMPLETED BY ALL ADMINISTERING VEsI CERTIFY THAT I HAVE COMPLIED WITH THE ADMINISTERING VE REQUIRMENTS IN PART 97 OF THECOMMISSION S RULES AND WITH THE INSTRUCTIONS PROVIDED BY THE COORDINATING VEC AND THE FCC. 1st VEs NAME (Print First, MI, Last, Suffix) VEs station CALL SIG N VEs SIG NATURE (Must match name) DATE SIG NED 2nd VEs NAME (Print First, MI, Last, Suffix) VEs station CALL SIGN VEs SIGNATURE (Must match name) DATE SIGNED 3rd VEs NAME (Print First, MI, Last, Suffix) VEs station CALL SIGN VEs SIGNATURE (Must match name) DATE SIGNEDType ofAmateurMili tar y RACE SApplicant.

3 IndividualClu bRecreation (Modify Only ) (Last name) (Su ffix) (First name) (MI ) PURPOSE OF OTHER APPLICATION PENDING FILE NUMBER (FOR VEC USE ONLY) DATE OF EXAMINATION SESSION EXAMINATION SESSION LOCATIONVEC ORGANIZ ATION VEC RECEIPT DATENCVEC form 605 - February 2010 FOR VE/VEC USE ONLY - Page 1Do you have another license APPLICATION on fil ewith the FCC which has not been acted upon ?CLUB, MILITARY RECREATION, OR RACES CALL SIGNSIGNATURE OF RESPONSI BLE CLUB OFFICIAL (not trustee )Appli can t is quali fied for opera tor licen se cla ss : NO NEW license OR UPGRADE WAS EARNED TECHNICIANE lement 2 GENERALE lemen ts 2 and 3 AMATEUR EXTRAE lements 2, 3 and 4DO NOT SEND THIS form TO FCC THIS IS NOT AN FCC THIS form IS SENT TO FCC, FCC WILL RETURN IT TO YOU WITHOUT TRUCTIO NS FOR CO MPLE TING APPLI CA TIO N F ORM NCV EC F ORM 605 AMATEUR RADIO LI CENSE L EVELS & REQUIREMENTSAs o f Ap ri l 15 , 2 00 0, you may be e xam ine d on o nl y th ree clas ses o f o pe rat or l icen ses , e ac h au th ori ]ing v aryin g level s o f pri vile ge s.

4 Curre nt ly th ere are th ree l icen se cla ss es , Tec hn icia n, *en era l a nd Ex tra . T he Fe de ral Com mun icat ion s Com mis sio n (FCC) gra nts th es e lic en ses . Tech nici an Cl ass L ice nseEXAM: 3 5-qu es ti on T ec hn ic ia n Wri tte n Ex am (El em en t 2 )PRI9I LE*ES: All 9+F/ U+F amat eu r band s (fr equen cie s ab ove 30 M +] ) a nd c er ta in +F fre qu en cie s o n th e 80 , 4 0, a nd 1 5 met er ba nd s u sing CW , a nd o n th e 10 m et er ba nd u sing CW , voi ce, a nd d igi ta l mod es . Gen era l Cl ass L ice nse (u pg rad e fro m T ec hn ician ) EXAM: 3 5-qu es ti on *en er al W ri tte n Ex am (El em en t 3 ) PRI9IL E* ES: Al l 9+F/U+F amat eu r b an ds a nd m os t +F pri vile ge s (1 0 th ro ug h 16 0 met ers ). In a dd it ion to th e Tec hn ic ian p ri vile ge s, *en er al Cl as s op era to rs a re au th or i]ed to o pe rat e on a ny fre qu en cy i n th e 16 0, 3 0, 1 7, 1 2, an d 10 met er ba nd s.

5 T he y m ay al so us e sig ni fi can t s eg men ts o f t he 8 0, 4 0, 2 0, a nd 1 5m et er ba nd s. Extr a Class license ( upgra de fr om *e ner al) EXAM: 5 0-qu es ti on Ex tra W ri tte n Ex am (El em en t 4 ) PRI9 ILE* ES: Al l am at eu r p ri vile ge s. Sho ul d you h ave a ny qu es ti on s, c on tac t o ne o f t he 1 4 volunte er exam in er c oo rd in at or (9EC) orga ni ]at ion s on g. T o c on ta ct t he FCC, cal l 88 8-22 5-53 22 (w ee kda ys), or wri te to FCC, 127 0 Fa irfi el d Roa d, *ett ysbu rg PA 17 325-72 45 . Als o s ee th e FCC web site http ://w irel es s. fcc .go v/s erv ic es /in de x. htm ?j ob= se rv ic e_ home&id=amat eurARE WRI TTE N TESTS AN F CC LI CE NSE RE QUI RE MENT? ARE T HE RE EXEMPTIONS ?The Am at eu r Ope rat or /Pri mar y Sta ti on L icense class f or which an e xam in ee q ua li fi es fo r is d et erm ine d by th e ex am s ta ken a t a 9E test s es sion.

6 The e xam s c over regu la ti on s, o pe rat ing pra ctic es , a nd e le ctro ni cs th eo ry . The re is n o e xempt ion fro m th e wri tte n ex am re qu ir em en ts fo r p ers ons w ith d if ficulty in rea di ng , w ri ti ng , o r b ec au se of a h an di cap o r d isabi li ty . The re ar e e xam accommodat ions th at c an b e af fo rd ed e xam ine es . Mos t n ew a mat eu r o pe rat ors s ta rt a t t he T ec hn ic ian c las s a nd th en a dvan ce on e c las s a t a ti me. F CC rul es p rovid e fo r examin ati on e lem en t c red it i n som e cas es , l ic en ses th at w ere pre viou sly he ld s o th at e xam ina ti on s re qu ired fo r t ha t l icens e ne ed n ot b e rep ea te d. T he w ri tte n ex am in at ion s a re con stru cte d fro m q ue sti on p oo ls th at a re in pu bl ic do mai n, see : g. +el pf ul study gu ide s and train ing cou rses are al so wid el y a vai lab le.

7 T o lo cat e ex am ina ti on o pp or tu ni ti es i n you r a re a, c on ta ct you r l oc al c lub , 9E gr ou p, o ne o f t he 1 4 9 ECs or see th e on li ne l is ti ng s o M ORSE CODE AN FCC LI CE NSE RE QUI RE MENT? Beg inn ing Fe bru ar y 2 3, 2 00 7, th e FCC no l on ge r re qu ir es pa ssing a M ors e cod e ex am in at ion fo r a ny Am at eu r Ra di o license class. SOCI AL SE CU RITY NUM BE RUnd er th e Deb t Co lle cti on Ac t o f 1 99 6 you r T ax pa yer ID Nu mber ( TIN), w hi ch is your Soc ial Se curi ty Num be r, is req ui red o n th is a pp li cat ion -- or your FCC-a ssigned F edera l Reg is tra ti on Num be r (F RN). An FRN is as sign ed b y th e FCC reg istra ti on s yste m a s s oo n as y ou r SSN is re gi ste red .REN EWIN G O R MODIF YIN G YO UR AMATEUR RA DI O OPERA TOR/P RI MARY STATIO N LI CE NS ENCVE C FO RM 6 05 The NC9EC fo rm 6 05 m ay al so be u sed to re ne w o r m od ify you r Am at eu r Rad io Ope ra to r/Prim ary Stati on l icen se.

8 L icen se ren ew al s (w ith as soc ia te d fe e fo r vani ty re ne wal s) m ay o nl y b e completed dur ing th e fi na l 9 0 da ys p ri or to l icen se ex pi rat ion , or up to tw o yea rs a fte r e xpi rat ion . Ch an ge s to y ou r m ai lin g ad dre ss, n am e an d re qu es ts fo r a s eq ue nt ial c ha ng e of y ou r sta ti on c al l s ig n ap pr op ri at e fo r y ou r l icens e clas s m ay be req ue sted a t a ny ti me. T hi s form m ay no t b e us ed to a pply fo r a ne w s pe cif ic 9a ni ty s ta ti on c al l sign . Do n ot s en d or p rovid e this f orm t o t he FCC - th is fo rm is fo r 9E / 9EC use on F CC APPLI CA TIO N form 605 The FCC ver sion o f t he fo rm 6 05 m ay no t b e us ed fo r applications submit te d to a 9E t ea m o r a 9EC sinc e it d oe s n ot req ue st i nf or mati on n ee de d by th e ad min iste ri ng 9E s.

9 T he FCC form 6 05 m ay ho wever, be u sed to ro ut ine ly re ne w o r mod ify y ou r l icen se wit ho ut c ha rge . Ne w v an ity l icen se req ue sts a nd v ani ty lic en se re ne wal s re quire a FCC regulatory fe e. FCC form 6 05 s ho ul d be s en t t o th e FCC, 127 0 Fa irfi el d Rd. , *et tysburg PA 17325-72 45 . F CC forms c an be o bt ai ne d via the FCC web at c. gov/fo rmp tm l or by f ax a t 20 2-41 8-01 77 . REN EWI NG O R MODI FYI NG YO UR AMATEUR LI CEN SEYou c an s ub mit you r re ne wal o r l icen se mod ifi cat ion s to F CC via the Intern et at: http :// wirel es s. fcc .g ov/uls/. I f you ar e al re ad y re gi ste re d in ULS a nd h ave o bt ai ne d a FRN (Fede ra l Reg is tra ti on Num be r), you c an c ho os e th e ON LI NE FILIN* / LO * IN l ink t o per for m your on-li ne tra ns ac ti on w ith th e FCC.

10 If you d o no t h ave a F RN, y ou m us t f ir st re gi ste r i n th e ULS b y fo ll ow in g th e New Us ers / Reg iste r l in k a nd c om pl et e you r reg istra ti on i nf orm at ion . You c an th en c ho os e th e Onl in e Filing / LO * IN link. D ire ct any o n-l ine f iling or password qu es ti on s to FCC Tec h Sup po rt wee kda ys a t 2 02-41 4-12 50 .CLUB station CALL SIGN ADM INISTRATORS (CSCSA)The NC9EC Fo rm 6 05 i s a lso us ed fo r th e pr oc es sin g of ap pl icat io ns fo r Am at eu r Se rv ice clu b an d mil it ar y re creati on sta ti on c al l s ig ns a nd fo r th e mod ifi cat ion o f RACES sta ti on s. Thi s fo rm m ay no t b e us ed to a pp ly fo r a n ew s pe cif ic 9a ni ty sta ti on c al l s ig n. T he Cl ub Sta ti on Cal l Si gn Ad min istra to rs are : ARRL/9EC 225 Mai n St., Ne wing to n, CT 0 61 11 , W49EC POB 4 1 Lexington, NC 27293-0 041 and t he W5YI-9E C P OB these three CS CSA 9EC FOR M 605 Febr uar y 2010 - Pa ge 2200065, Arlington, TX 76006.