A                                                              
                                                                           
_____ R   R ____________________________________________________________________
                          (Do not write above line)                         
        L                                                         [] Novice 
                          ARRL NOVEMBER SWEEPSTAKES               [] Technician
                                                                  [] Other 
                                    [] CW               
                                    [] PHONE           
  
CALL USED ______________________ PRECEDENCE_____ CHECK______ SECTION ___________
  
CALL OF OPERATOR IF DIFFERENT FROM CALL USED____________________________________
  
[] Single Operator                                         
[] Multioperator (list calls of ops)____________________________________________
  
SCORING: __________QSO points X __________sections = _______________claimed score
  
Count 2 points per complete QSO.    [Cross out sections on the list below.] 
+---------------+ +-------------+ +-------------+ +-------------+ +-------------+
|               | |             | |             | |             | |             |
+---------------+ +-------------+ +-------------+ +-------------+ +-------------+
 Claimed Score     QSOs            Sections        Power Output    Hrs of Op
  
+------------------------------------------------------------------------------+
| Club participation?   Yes_____  No_____                                      |
| ARRL Affiliated Club:________________________________________________________|
+------------------------------------------------------------------------------+
  
Rig:______________________________ Antenna:_____________________________________
  
"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            |
|      CT   ENY  DE    AL    AR    EB    AZ    MI    IL    CO    MAR           |
|      EMA  NLI  EPA   GA    LA    LAX   EWA   OH    IN    IA    PQ            |
|      ME   NNJ  MDC   KY    MS    ORG   ID    WV    WI    KS    ON            |
|      NH   SNJ  WPA   NC    NM    SB    MT                MN    MB            |
|      RI   WNY        NFL   NTX   SCV   NV                MO    SK            |
|      VT              SC    OK    SDG   OR                NE    AB            |
|      WMA             SFL   STX   SF    UT                ND    BC            |
|                      TN    WTX   SJV   WWA               SD    YU/NWT        |
|                      VA          SV    WY                                    |
|                      PR          PAC   AK                                    |
|                      VI                                                      |
+------------------------------------------------------------------------------+
  
Print or type:
  
NAME_____________________________________ CALL______________
  
ADDRESS_____________________________________________________
  
____________________________________________________________