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- ARRL INTERNATIONAL DX CONTEST
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- [] CW
- [] PHONE
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- CALL USED ______________________________ ARRL SECTION or COUNTRY_______________
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- CALL OF OPERATOR IF DIFFERENT FROM CALL USED____________________________________
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- CHECK ONE:
- Valid QSOs MULTIPLIERS
- [] Novice/Technician +-------------------------------------+
- | 160 | | |
- Single Operator |-------------------------------------|
- | 80 | | |
- [] All Band |-------------------------------------|
- [] Single Band (circle one) | 40 | | |
- 160 80 40 20 15 10 |-------------------------------------|
- [] QRP (5W or less output) | 20 | | |
- [] Assisted |-------------------------------------|
- | 15 | | |
- Multioperator |-------------------------------------|
- | 10 | | |
- [] Single transmitter |=====================================|
- [] Two transmitter |Total| | |
- [] Unlimited +-------------------------------------+
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- If multioperator, list calls of all operators and loggers:
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- _______________________________________________________________________________
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- Please enclose log, photos, comments, ideas, etc. with your entry and mail
- promptly to: ARRL Contests, 225 Main Street, Newington, CT 06111.
-
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- _____________ X 3 = _____________ X ____________ = ___________________________
- Valid QSOs QSO Points Multipliers Claimed Score
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- POWER OUTPUT: [] 5 watts or less [] 6-150 watts [] Over 150 watts
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- +------------------------------------------------------------------------------+
- | Club participation? Yes_____ No_____ |
- | ARRL Affiliated Club:________________________________________________________|
- +------------------------------------------------------------------------------+
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- "I have observed all competition rules as well as all regulations for Amateur
- Radio in my country. My report is correct and true to the best of my knowledge.
- I agree to be bound by the decisions of the ARRL Awards Committee."
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- Date ______________ Signature _______________________________ Call _____________
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- Print or type:
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- NAME_____________________________________ CALL______________
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- ADDRESS_____________________________________________________
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- ____________________________________________________________
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