home *** CD-ROM | disk | FTP | other *** search
/ QRZ! Ham Radio 5 / QRZ Ham Radio Callsign Database - Volume 5.iso / files / arrl / msd / fd.frm < prev    next >
Encoding:
Text File  |  1994-11-20  |  5.4 KB  |  94 lines
  1.                                 Field Day
  2.  
  3.   1. Field Day Call Used _______________
  4.  
  5.   2. Club or  group name ____________________________________________________
  6.  
  7.   3. Field Day location  ____________________________________________________
  8.  
  9.   4. Check if you began    5. Number of people      6. Number of trans-
  10.      set-up prior to          participating in         mitters in simul-
  11.      1800 UTC Saturday. ___   this operation.  ____    taneous operation. _____
  12.  
  13.   7. ARRL/Canadian Section _____________  
  14.  
  15.   8. Entry Class
  16.      (check one only)
  17.  
  18.      __ A. Club or non-club      11. *---------------------------------------*
  19.                                      |        CW         #       PHONE       |
  20.      __ B. Non-club portable         |-------------------#-------------------|
  21.           1 op ___                   |     QSOs  |PWR OUT#     QSOs  |PWR OUT|
  22.           2 op ___                   |---|-------|-------#---|-------|-------|
  23.           List operators             |160|       |       #160|       |       |
  24.           __________________         |---|-------|-------#---|-------|-------|
  25.                                      | 80|       |       # 80|       |       |
  26.     __ C. Mobile                     |---|-------|-------#---|-------|-------|
  27.                                      | 40|       |       # 40|       |       |
  28.     __ D. Home Station               |---|-------|-------#---|-------|-------|
  29.           (commercial power)         | 20|       |       # 20|       |       |
  30.                                      |---|-------|-------#---|-------|-------|
  31.     __ E. Home Station               | 15|       |       # 15|       |       |
  32.           (emergency power)          |---|-------|-------#---|-------|-------|
  33.                                      | 10|       |       # 10|       |       |
  34.   9. Power Source                    |---|-------|-------#---|-------|-------|
  35.                                      |  6|       |       #  6|       |       |
  36.     __ Generator         __ Battery  |---|-------|-------#---|-------|-------|
  37.     __ Commercial Mains  __ Other    |  2|       |       #  2|       |       |
  38.                                      |---|-------|-------#---|-------|-------|
  39.   10. Call sign of Novice/Technician | OTHERS            # OTHERS            |
  40.      station (class 2A and above)    |___________________#___________________|
  41.      ____________                    |   |       |       #   |       |       |
  42.                                      |   |       |       #   |       |       |
  43.                                      |---|-------|-------#---|-------|-------|
  44.  12. Total                           |   |       |       #   |       |       |
  45.                                      |   |       |       #   |       |       |
  46.      CW QSOs _____ X 2 = _________   *---------------------------------------*
  47.                                      *---------------------------------------*
  48.                                      |           |  CW   #           | Phone |
  49.      Total                           |           | QSOs  #           | QSOs  |
  50.                                      |-----------|-------#-----------|-------|
  51.      Phone QSOs ____ X 1 = _______   |           |Novice #           |Novice |
  52.                                      |           |CW QSOs#           |Ph.QSOs|
  53.                                      |-----------|-------#-----------|-------|
  54.      Total QSO points      ________  |           | Total #           | Total |
  55.                                      |           |CW QSOs#           |Ph.QSOs|
  56.                                      *-------------------#-------------------*
  57.  
  58.  13. Total QSO points _______ X Power Multiplier (5W or less, X5; 150W or
  59.  
  60.      less, X2; over 150W, X1)   _______  equals Claimed Score (less
  61.  
  62.      bonus points)  ___________
  63.  
  64.  14. Bonus Points            __ 100% Emergency Power   __ Messages handled 
  65.                                                            (no.) ________   
  66.      Attach proof required   __ Media Publicity                            
  67.      for all bonus points                              __ Satellite        
  68.      claimed. All bonus      __ Location in a                              
  69.      points will be added       public place           __ Natural  Power   
  70.      at ARRL HQ                                                            
  71.                              __ Information booth      __ Packet Radio    
  72.                                                                            
  73.                              __ Message to SM          __ VHF/UHF 
  74.                                                        
  75.                              __ W1AW Field Day message __ Other _________
  76.  
  77.  15. This certifies that the station whose call appears above was operated
  78.      in accordance with the current field day rules and that, to the best of
  79.      my knowledge, the points and scores set forth in the above summary are
  80.      correct and true. This station was operated in accordance with FCC
  81.      rules and regulations. I agree to be bound by any decision of the ARRL
  82.      Awards Committee.
  83.  
  84.   Date _________  Signed ________________________ Call __________
  85.                          signature/call of club president
  86.  
  87.  16. Full mailing address (please print)
  88.  
  89.   Name    _______________________________
  90.  
  91.   Address _______________________________
  92.  
  93.           _______________________________
  94.