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60ºPARALELL NORTH AWARD
60ºParalell North Award
Application Name_____________________________________________________________________________ {As
you would like it to appear on award} Address___________________________________________________________________________
Postal
code_________________________
City____________________________________________ Country____________________________________________________________________________
Phone____________________
EMail____________________ CALLSIGN______________________ Log
| STATION | DATE | TIME UTC | BAND | MODE | RST | QTH | |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................| |..........................|....................|...........................|..................|................|..............|........................................|
I certify, on my honor, that have observed all regulations established for amateur radio in my country as well as the award rules. _______________________________________ Operator
We certify, that all QSL's have been checked and found true and correct in accordance with log.
________________________________________ Two Names and Callsigns Award Manager Representative Cost
of the award € 5,00 or 10 IRC’s
is $12 US Send
application, prefix list, certification statement, and payment to: Manuel
Alberto C. Marques (CT1BWW) E-Mail
– ct1bww @ cwhamradio.com
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or other proprietary statement goes here. This is NOT a Commercial Site! |
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