Submit this form to notify the FRC that your repeater is active and operating in compliance with its current coordination. Fields marked with an asterisk are REQUIRED. Entry of an invalid email address will cause your application to be discarded and not processed (e-mail addresses are kept confidential). Applications that are submitted with erroneous, conflicting or missing information will be returned to the applicant unprocessed. The applicant may re-submit the application but the original date of submission will not be honored. By entering my name and date in the boxes below, I CERTIFY that the information provided below is complete and accurate, and that the repeater is ACTIVE (IN SERVICE). *Licensee's full name: *Licensee's Call Sign: (Supply the name and callsign of the TRUSTEE not the SPONSOR (or club) *E-mail address: *Date submitted (MM-DD-YY): *Holder of the coordination: (This is the individual or group that controls the coordination and has the authority to change the trustee or "Holder" information, transfer or relinquish the coordination, or change its technical parameters. See our Coordination Policy, section 7 for more information). *Address: *City: *State: *Zip: *Phone: () *Repeater callsign: *Output frequency: *Repeater city: *County: *District: (click HERE for a map and county list)