Incident Reporting Form

This form is to be used when requesting assistance to locate a recreational vessel believed to be significantly overdue at a destination, has not been heard from for an unusually long period of time, or for the purpose of getting an urgent message to the crew of a vessel as in the case of serious illness or a death in the family.  We do not involve ourselves with commercial vessels, and we request that you refrain from using this service for contacts of little significance (e.g. birthday greetings, general inquiries of "how's the trip going", etc.).

Given those guidelines above, please proceed to provide as much of the following requested information as possible.

To begin this Boat Watch request form, we need to know who you are and how we may be in touch with you (Submitter of this form). Tell us how to get in touch with you: (use "TAB" key after each entry.)
Full Name:
Street Address:
Address (cont.):
City, State:
Zip/Postal Code:
Country:
Work Phone:	(include area code)
Home Phone:	(include area code)
E-mail:
What is the nature of this request?  (please select one of the options below) Lost or Overdue Vessel                Urgent Message Now let's describe the vessel. (Please preface vessel name with "S/V" for sailing vessel, or "M/V" for motor vessel.) Enter Vessel Name: Enter vessel description (length, color, sail configuration (sloop, ketch, etc), aft/mid cockpit, bimini color, wind vane, dinghy type and color, etc.) Next, it is helpful to know what communications capabilities are on board.  Please indicate marine VHF, marine SSB, Amateur Radio, WinLink 2000, etc.  Please indicate any known radio networks frequented if known.  When was the last radio contact, on what frequency, and where was vessel then?  Was a position report given? What is the vessel's itinerary, where and when were they last contacted, what is their destination and ETA? How many people are on board (give approximate ages, sex, and names if available) Now we are at the real meat of the report, that being to let us know why we are looking for this vessel (vessel is long over due at destination (name);  vessel hasn't been heard from since (date) from (place);  or need to have crew call home for an important message (ex. serious illness or death in family).  Please give name of person on vessel to address this message to.  You may paraphrase the message to be delivered and include any names and phone numbers for the recipient to contact. Lastly, we must know when this message has been successfully delivered so that we may close out the record of this incident.  Normally we expect the originator of this form to accept that responsibility.  Such notification may be sent via e-mail to wloradio@wloradio.com or through contact with the Maritime Mobile Service Net on 14.300 MHz.  We will attempt to contact you via e-mail when we have received any information about the vessel. The following space is provided for any additional information you wish to provide.