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ELT Beacon Registration

Please Note:
This form is for information gathering only to aid Ducey Avionics in registering 406Mhz ELTs on behalf of their customers. To register an ELT, you must contact the Canadian Beacon Registry at www.canadianbeaconregistry.forces.gc.ca

Please fill in all appropriate fields

Registrant Name
A value is required.
Street Address
A value is required.
City
A value is required.
Province
A value is required.
Postal Code
A value is required.
Country
A value is required.
email address

A value is required.Invalid format.
Home Telephone
A value is required.
Work Telephone
A value is required.
Cell
Fax
Other

Aircraft Information

Manufacturer
A value is required.
Model
A value is required.
Home Airport
A value is required.
Registration Mark
A value is required.
Number of engines
Crew
A value is required.
Seats
A value is required.
Primary Colour
A value is required.
Secondary Colour
A value is required.
Distinctive Feature
Additional Info


Radio Information

VHF/FMMFHF/SSB
Other


Propulsion Type

PistonTurbo JetTurbo Fan
Turbo PropTurbo ShaftNone
Other


Aircraft Type

AeroplaneHelicopterGliderGyroplane
Other


Required Emergency Contact Information



Primary Contact

Primary Contact
A value is required.
Relationship
A value is required.
Home Telephone
A value is required.
Work Telephone
Cell
Other

Secondary Contact

Secondary Contact
A value is required.
Relationship
A value is required.
Home Telephone
A value is required.
Work Telephone
Cell
Other
Notes




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