home *** CD-ROM | disk | FTP | other *** search
/ QRZ! Ham Radio 1 / QRZ Ham Radio Callsign Database - December 1993.iso / arrl / form_dx < prev    next >
Text File  |  1993-11-21  |  3KB  |  66 lines
  1.                                                                       A    
  2.                                                                                
  3. ___________________________________________________________________ R   R ______
  4.                           (Do not write above line)                         
  5.                                                                       L      
  6.                         ARRL INTERNATIONAL DX CONTEST
  7.   
  8.                                     [] CW
  9.                                     [] PHONE  
  10.   
  11. CALL USED ______________________________  ARRL SECTION or COUNTRY_______________
  12.   
  13. CALL OF OPERATOR IF DIFFERENT FROM CALL USED____________________________________
  14.   
  15. CHECK ONE:                                                    
  16.                                                 Valid QSOs      MULTIPLIERS   
  17.   [] Novice/Technician                 +-------------------------------------+
  18.                                        | 160 |               |               |
  19. Single Operator                        |-------------------------------------|
  20.                                        |  80 |               |               |
  21.   [] All Band                          |-------------------------------------|
  22.   [] Single Band (circle one)          |  40 |               |               |
  23.      160  80  40  20  15  10           |-------------------------------------|
  24.   [] QRP (5W or less output)           |  20 |               |               |
  25.   [] Assisted                          |-------------------------------------|                                                    
  26.                                        |  15 |               |               |
  27. Multioperator                          |-------------------------------------|
  28.                                        |  10 |               |               |
  29.   [] Single transmitter                |=====================================|
  30.   [] Two transmitter                   |Total|               |               |
  31.   [] Unlimited                         +-------------------------------------+
  32.   
  33. If multioperator, list calls of all operators and loggers:
  34.   
  35. _______________________________________________________________________________
  36.   
  37. Please enclose log, photos, comments, ideas, etc. with your entry and mail
  38. promptly to: ARRL Contests, 225 Main Street, Newington, CT 06111.
  39.   
  40.  
  41. _____________ X 3 = _____________ X ____________ = ___________________________ 
  42.  Valid QSOs          QSO Points     Multipliers           Claimed Score
  43.   
  44. POWER OUTPUT:   [] 5 watts or less    [] 6-150 watts    [] Over 150 watts
  45.   
  46. +------------------------------------------------------------------------------+
  47. | Club participation?   Yes_____  No_____                                      |
  48. | ARRL Affiliated Club:________________________________________________________|
  49. +------------------------------------------------------------------------------+
  50.   
  51. "I have observed all competition rules as well as all regulations for Amateur 
  52. Radio in my country. My report is correct and true to the best of my knowledge.
  53. I agree to be bound by the decisions of the ARRL Awards Committee."
  54.   
  55. Date ______________ Signature _______________________________ Call _____________
  56.   
  57. Print or type:
  58.   
  59. NAME_____________________________________ CALL______________
  60.   
  61. ADDRESS_____________________________________________________
  62.   
  63. ____________________________________________________________
  64.  
  65.  
  66.