Join Now! (Step1)

( * ) Field Must Be Entered 

First Name:  * Last Name:  * Email Address:  * Street Adress: * City: * State: Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code: * Home Phone Number: - - Cell Phone Number: Employer: Job Title: Date of Birth: Month: January February March April May June July August September October November December Date: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year: 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 (You must be 18 years of age or older to join) Have you ever been convicted of a crime?     No Yes Why do you seek membership with NECW? Is there a current NECW Member that will vouch for you?     No Yes Are you a Dispatcher with 1st Responder Wireless News (1RWN)?     No Yes Are you a Dispatcher with any Incident Notification Service, other than 1RWN?     No Yes Are you a Member of any other Buff Radio Group?     No Yes Preference of member ID numbers.     (i.e. NJ20, NJ55, etc.) List your first 3 choices. (If you are a 1RWN Dispatcher, only list your 1RWN ID) Yes  No Do you affirm that the information provided above is complete and accurate? Providing information that is false, inaccurate or misleading, will automatically void your application and membership & forfeit your dues to NECW. Furthermore, you understand that NECW reserves the right to perform a background check at anytime.