A    
                                                                               
___________________________________________________________________ R   R ______
                          (Do not write above line)                         
                                                                      L      
                             ARRL VHF QSO PARTY
 
                                 [] JUNE                                                        
                                 [] SEPTEMBER         GRID SQUARE ______________     
 
CALL USED ______________________________  ARRL SECTION or COUNTRY_______________
 
CALL OF OPERATOR IF DIFFERENT FROM CALL USED____________________________________
 
[] Single operator multiband                      [] Novice single operator
[] Single operator single band ________ MHz       [] QRP Portable
                                                  [] Rover
[] Limited Multioperator                          
[] Multioperator.  If multioperator, list calls of all operators and loggers:
 
_______________________________________________________________________________
 

             Valid QSOs   QSO Points  Multipliers         Claimed Score
+------------------------------------------------------------------------------+
|  50 MHz  |            |            |            |                            |
|(1 pt ea) |            |            |            |                            |
|----------|------------|------------|------------|----------------------------|
| 144 MHz  |            |            |            |                            |
|(1 pt ea) |            |            |            |                            |
|----------|------------|------------|------------|----------------------------|
| 220 MHz  |            |            |            |                            |
|(2 pts ea)|            |            |            |                            |
|----------|------------|------------|------------|----------------------------|
| 432 MHz  |            |            |            |                            |
|(2 pts ea)|            |            |            |                            |
|----------|------------|------------|------------|----------------------------|
| 902 MHz  |            |            |            |                            |
|(3 pts ea)|            |            |            |                            |
|----------|------------|------------|------------|----------------------------|
|1296 MHz  |            |            |            |                            |
|(3 pts ea)|            |            |            |                            |
|----------|------------|------------|------------|----------------------------|
| 2300 +   |            |            |            |                            |
|(4 pts ea)|            |            |            |                            |
|==============================================================================|
|   Total  |            |            |            |                            |  
| All Bands|            |            |            |                            |
+------------------------------------------------------------------------------+
 
"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 _____________
 
Print or type:
 
NAME_____________________________________ CALL______________
 
ADDRESS_____________________________________________________
 
____________________________________________________________