Request for FAA/FCC Tower Registration
Licensee Name: ${legal_licensee_name}
Contact Name: ${contact_person_name}
Address: ${address_1} ${address_2}
City: ${transmitter_location_city_1}
State & Zip: ${transmitter_location_state_1} ${zip}
County: ${transmitter_location_county_1}
Phone: ${phone}
Fax: ${fax}
Email: ${licensee_email}
Ground elevation: ${ground_elevation}
Antenna Height above ground: ${antenna_height_1}
Antenna Mounted on: ${antenna_mounted_on_1}
${antenna_mounted_on_other_1}
Height of structure: ${structure_height_1}
Additional Comments: ${additional_comments}