| Call Sign: | |
| First Name: | |
| Last Name: | |
| Email: | |
| City: | |
| State (2-letter All Caps Abbreviation): | (provide Country below if outside US) |
| Country (2-letter All Caps Abbreviation): | |
| Zip Code (max 5 numerical characters): | (US only please) |
| Elevation (meters): | |
| Website (optional): | |
| Reporting Observations (optional): | |
| Weather Software (optional): | |
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