States Above 50 MHz Award Contest Summary & Application for Award

YOUR CALLSIGN ______________

YOUR LOCATION ______________

  STATES/PROV
BAND WORKED
50 MHz  
144 MHz  
222 MHz  
432 MHz  
902 MHz  
1296 MHz  
2304 MHz  
3456 MHz  
5760 MHz  
10 GHz  
24 GHz  
47 GHz  
76 GHz  
120 GHz  
142 GHz  
241 GHz  
>300 GHz  
TOTAL:  

The undersigned affirms that he/she has read, understood, and abided by the rules of the CSVHF Society "States Above 50 MHz" Award. The above entry is for (circle one):

MULTI-OPERATOR  or  SINGLE OPERATOR  or  ROVER  Category.

Signature ________________________________ Date _____________

(Please Print)

Name_____________________________     Callsign_________________

Street: ______________________________________________________

City: ________________________________________________________

State/Province: _______________ Zip/Postal code: ___________

E-mail: ____________________________

 

BACK