ARRL

Ethiopia Application Form

Application for Radio License

 

NO.

Name of applicant Status
Nationality Address

License required by

 

PO Box Telephone

Reason for requesting license

 



Requested duration of license

Particulars of Radio Communication Equipment

Manufacturer Model Power Serial No. Quantity

 



Location of Radio Station Type of Station
Region Province District Locality Base, Mobile, Other

 



Communication circuit Air Distance (km) Frequency Emission Type of Antenna Operating Time

 



Place Date Signature & Stamp

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