A        
                                                                               
___________________________________________________________________ R   R ______
                          (Do not write above line)                         
                                                                      L      
                            ARRL 10-METER CONTEST
 
 
CALL USED ______________________________  ARRL SECTION or COUNTRY_______________
 
CALL OF OPERATOR IF DIFFERENT FROM CALL USED____________________________________
 
CHECK ONE:
Single Operator   Power Output                     License Class        
  [] Phone & CW     [] QRP (5 W or less)             [] Novice    
  [] Phone only     [] Low Power (150 W or less)     [] Technician   
  [] CW only        [] High Power (more than 150 W)  [] Other                                 
                                                                                
[] Multioperator                         
 
If multioperator, list calls of all operators and loggers:
 
_______________________________________________________________________________
 
__________QSO ponits* X __________Multipliers = _______________ Claimed score.
 
*Count 2 pts per phone QSO, 4 pts per CW QSO and 8 pts per US Novice/Tech CW QSO 
 
+------------------------+ +----------------+ +----------------+ +-------------+
|                        | |                | |                | |             |
+------------------------+ +----------------+ +----------------+ +-------------+
 Claimed Score               QSOs               Multipliers        Hrs of Op
 
"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."
 
Date ______________ Signature _______________________________ Call _____________
 
Please enclose log, photos, comments, ideas, etc. with your entry and mail
promptly to: ARRL Contests, 225 Main Street, Newington, CT 06111.
 
+-----------------------< MULTIPLIER CHECK-OFF LIST >--------------------------+
|  1    2    3     4     5     6     7     8     9     0       VE        DX    |
|  CT   NY   DC    AL    AR    CA    AZ    MI    IL    CO    NB   NF           |
|  MA   NJ   DEA   FL    LA    HI    ID    OH    IN    IA    NS   LAB          |
|  ME        MD    GA    MS          MT    WV    WI    KS    PEI  NWT          |
|  NH        PA    KY    NM          NV                MN    PQ   YUK          |
|  RI              NC    OK          OR                MO    ON                |
|  VT              SC    TX          UT                NE    MB                |
|                  TN                WA                ND    SK                |
|                  VA                WY                SD    AB                |
|                                    AK                      BC                |
+------------------------------------------------------------------------------+
 
Print or type:
 
NAME_____________________________________ CALL______________
 
ADDRESS_____________________________________________________
 
____________________________________________________________