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  1.         A                                                              
  2.                                                                            
  3. _____ R   R __________________________________________________________________
  4.                           (Do not write above line)                         
  5.         L                                                        [] Novice 
  6.                               ARRL RTTY ROUNDUP                  [] Technician
  7.                                                                  [] Other 
  8.   
  9. CALL USED ______________________ SECTION or COUNTRY (for DX) __________
  10.   
  11. CALL OF OPERATOR IF DIFFERENT FROM CALL USED___________________________________
  12.   
  13. [] Single Operator                                         
  14. [] Multioperator (list calls of ops)___________________________________________
  15.  
  16. [] Less than 150 W output            +---------------+
  17. [] 150 W output or more              |               |
  18.                                      +---------------+
  19.                                      Hours of Operation  
  20.  
  21.   
  22.                  +---------------+   +-------------+   +---------------+
  23. SCORING:         |               | X |             | = |               | 
  24.                  +---------------+   +-------------+   +---------------+
  25.                     Total QSOs         Multipliers        Claimed Score
  26.   
  27. "I have observed all competition rules as well as all regulations for Amateur 
  28. Radio in my country. My report is correct and true to the best of my knowledge.
  29. I agree to be bound by the decisions of the ARRL Awards Committee."
  30.   
  31. Date ______________ Signature _______________________________ Call ____________
  32.   
  33. Please enclose log, photos, comments, ideas, etc. with your entry and mail
  34. promptly to: ARRL Contests, 225 Main Street, Newington, CT 06111.
  35. Upload to BBS: 203-665-0090          Internet: contest@arrl.org
  36.   
  37. +-----------------------< MULTIPLIER CHECK-OFF LIST >-------------------------+
  38. | 1    2    3     4     5     6     7     8     9     0       VE         DX   |
  39. | CT   NY   DE    AL    AR    CA    AZ    MI    IL    CO    NB  NF/LAB        |
  40. | MA   NJ   MD    FL    LA          ID    OH    IN    IA    NS   NWT          |
  41. | ME        PA    GA    MS          MT    WV    WI    KS    PEI  YUK          |
  42. | NH              KY    NM          NV                MN    PQ                |
  43. | RI              NC    OK          OR                MO    ON                |
  44. | VT              SC    TX          UT                NE    MB                |
  45. |                 TN                WA                ND    SK                |
  46. |                 VA                WY                SD    AB                |
  47. |                                                           BC                |
  48. +-----------------------------------------------------------------------------+
  49.   
  50. NAME_____________________________________ CALL______________
  51.   
  52. ADDRESS_____________________________________________________
  53.   
  54. ____________________________________________________________
  55.