Coordination Request Form

Which frequency band are you applying for?
Are the receiver and transmitter sharing a common antenna?
Which frequency band are you applying for?
Check all of the modes that are enabled on the repeater.
Enter the frequency of the record you are updating.
Input the repeater's transmitter frequency.
Please select the repeater transmitter CTCSS/DCS code.
Please select the repeater receiver CTCSS/DCS code.
Select which standard offset is used. If non-standard, enter the uplink freq. below
Please enter the repeater ID issued by RadioID.net.
Is this repeater Open to the public?
Does your organization have a website you would like to have published?
Please check all of the features that apply.
Enter the node number.
Enter the node number.
Enter the node number.
Append -L or -R if used.
Enter the RF Extension.
Height of the antenna centerline above ground. (Numbers only)
Height of the antenna centerline above ground. (Numbers only)
Enter the City or Town nearest to the Transmitter's location.
Enter the county the transmitter is located in.
Enter the City or Town nearest to the Receiver's location.
Enter as decimal degrees. Example: 39.34532
Enter as decimal degrees. Example: -97.26456
Enter as decimal degrees. Example: 39.34532
Enter as decimal degrees. Example: -97.26456
Select the region you wish this to be listed in.
Please include a brief description of the items to be updated.
Enter the callsign, name and contact information of the person who will assume the coordination upon your death.
By checking this box you are surrendering this coordination, and understand that the frequency or frequencies are immediately returned to the pool and available for re-assignment.
I certify that I am the custodian of record and that I have authorization to submit changes to this coordination.
Nebraska Repeaters on RepeaterBook

Email:  coordinator@nebraska-repeaters.us

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