ARRL 10 Meter Contest

			ARRL 10-Meter Contest 

Call Used _________________  ARRL SECTION/DXCC Entity ________________
                 
Operator Call (if different) or Multi-operators callsigns:

______________________________________________________________________
                 
Entry Category:  Select ONLY ONE:

  Single Operator                  Power Output:  Select ONLY One:                      
  [ ] Mixed Mode	           [ ] QRP (5 Watts or less)      
  [ ] Phone only                   [ ] Low Power (up to 150 Watts)      
  [ ] CW only                      [ ] High Power (more than 150 Watts) 			       			                       
  [ ] Multioperator (includes 
      any station using packet 
      assisted)                         
  
CW QSOS     _______________  x 4 points = CW QSO Points    __________
Phone QSOs  _______________  x 2 points = Phone QSO Points __________
Total QSOs  _______________               Total QSO Points __________     


US States Worked:              ___________   							
Canada Provinces/
Territories Worked:            ___________ 

Non-W/VE DXCC Entities Worked: ___________ 
Total Multipliers Worked:      ___________   

Total QSO Points  x  Total Multipliers Worked   =  Claimed Score

________________  X  ________________________   =  _________________    

ARRL Affiliated Club Competition? ___ Yes  ___ No
If Yes, please print club name below:

____________________________________________________________________     

   You can submit this log electronically at: www.b4h.net/cabforms

 
"I have observed all contest 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 ____________
                 

Name: _____________________________________________________________

Address:  _________________________________________________________
         
          _________________________________________________________

Email Address:  ___________________________________________________


1.  Dupe sheets must accompany log of 500 QSOs or more.
2.  Mailing deadline is 30 days after the end of the contest.
3.  Please enclose logs, dupe sheets, etc. and mail to:
    ARRL 10-Meter Contest
    225 Main Street
    Newington, CT 06111 USA


___________________________________________________________________                 
|  US / Canada Multipliers    (List DX multipliers on other side)  |	
|								   |	
|								   |
|  1   2   3     4     5    6     7     8     9    0        VE     |
|								   |	
|  CT  NJ  DC	 AL   AR    CA	  AK	MI    IL   CO	 NB    BC  |
|  MA  NY  DE	 FL   LA    HI	  AZ	OH    IN   IA	 NS    NF  |
|  ME	   MD	 GA   MS	  ID	WV    WI   KS	 PEI   LB  |	
|  NH 	   PA	 KY   NM	  MT		   MN	 QC    NWT |	
|  RI		 NC   OK	  NV		   MO	 ON    YT  |
|  VT		 SC   TX	  OR		   NE	 MB    NU  |
|		 TN		  UT		   ND	 SK	   |
|		 VA		  WA		   SD	 AB	   |
|				  WY 			           |	
|__________________________________________________________________|