1. Field Day Call Used __________WC4DC________________________________ GOTA Station Call ____________NY4N________________________________ 2. Club or Group name (if Class A station) _Dickson Co ARC_____________________ 3. Number of Participants ____17_________ 4. Number of Transmitters in simultaneous operation ____5__________ 5. Entry Class: Check only one. _x_ A. Club or non-club group portable ___ B. 1 or 2 person non-club Group portable List call of operators: ______________________________________ ___ C. Mobile ___ D. Home station commercial power ___ E. Home station emergency power 6. Check all power sources used ___ Generator ___ Commercial mains _x_ Battery _x_ Other (list) ___solar_______________________ 7. ARRL / RAC Section ____Tennessee__________________ 8. Total CW QSOs _531__________ x 2 = Total CW QSO points _1062__________ 9. Total Digital QSOs ___7____ x 2 = Total Digital QSO points __14____ 10. Total Phone QSOs __732_______x 1 = Total Phone QSO points _732________ 11. Total QSO Points ___1808__________________ 12. Power Multiplier (select only one) _x_ 5 Watts or less and Battery powered = 5 ___ 150 Watts or less = 2 ___ Over 150 Watts = 1 (transfer to line 13) 13. Power Multiplier ________5______________ 14. Claimed Score ____9040____________________ (line 11 x line 13) (excluding bonus points) 15. Bonus points claimed: Please check each block as appropriate and include required proof of points with your submission. All bonus points will be verified at ARRL HQ and added to your score. _x__ 100% Emergency power _x__ Media Publicity _x__ Set-up in Public Place _x__ Information Booth _x__ NTS message to ARRL SM/SEC _x__ W1AW Field Day Message _x__ Formal NTS messages handled (# __1________) ___ Satellite QSO completed _x__ Natural power QSOs completed _x__ Site Visited by invited officials ___ GOTA station maximum QSOs achieved _x__ Non-Traditional Demonstration modes (list each): A. ____SSTV_________________________________________ B. _____________________________________________ C. _____________________________________________ Total Bonus Points Claimed: ___1310________________ 16. I/We have observed all competition rules as well as all relations for amateur radio in my/our country. My/our report is correct and true to the best of my/our knowledge. I/We agree to be bound by the decisions of the ARRL Awards Committee. Date: _14 July 2002___________________________________________ Call: ___NY4N_________________________________________ Signature: ______Jeffrey L Clark___________________________________ (signature/call of club president or authorized club representative) Address: __P O Box 73_______________________________________ Address: __Dickson Tennessee 37056_______________________________ E-Mail Address: __NY4N @ AOL.Com_________________________________ You must complete the Band/Mode QSO breakdown box below. February 2002 - FD Form Field Day Call Used: ___WC4DC____________________ 17. ----------------------------------------------------- | CW | | Digital | | Phone | | | QSO | Power | QSO | Power | QSO | Power | __________|________|________|_________|________|_______|_______| 160 M | | | | | | | __________|________|________|_________|________|_______|_______| 80 M | | | | | | | __________|__61____|________|_________|__ ____|_43____|_______| 40 M | | | | | | | __________|__159___|________|_________|_ ____|_132___|_______| 20 M | | | | | | | __________|__132___|________|___7_____|________|_366___|_______| 15 M | | | | | | | __________|_142____|________|_________|________|_156___|_______| 10 M | | | | | | | __________|__36____|________|_________|________|_22____|_______| 6 M | | | | | | | __________|__1_____|________|_________|________|__1____|_______| 2 M | | | | | | | __________|________|________|_________|________|__1____|_______| 1.25 | | | | | | | __________|________|________|_________|________|_______|_______| Other | | | | | | | __________|________|________|_________|________|_______|_______| Other | | | | | | | __________|________|________|_________|________|_______|_______| Satelitte | | | | | | | __________|________|________|_________|________|_______|_______| GOTA | | | | | | | __________|________|________|_________|________|__11___|_______| Totals | | CW | |Digital | | Phone | __________|__531___|________|__7______|________|__732__|_______| Enter on Enter on Enter on Line 8 of Line 9 of Line 10 Summary Summary Summary 18. List all callsigns of all operators of the GOTA Station: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ GOTA QSOs must include an operator list in order for the QSOs to be included. Field Day Entry Submission Instructions: Please make certain that your required summary sheet is complete with the following fields filled in: 1. Field Day Call Used: The callsign used by your club/group/entry. If your group used a GOTA station please list that callsign in the space provided. 2. Club or Group Name: If your group entered as a Class A entry, please give us the name of the Club or Group. Only Class A entries will have group names listed in QST. 3. Number of Participants: Give the number of persons who participated in your Field Day operation. Include operators, loggers, set-up crew, and visitors. 4. Number of Transmitters in Simultaneous Operation: List how many transmitters were active during any 15-minute period of the Field Day event. 5. Entry Class: Refer to the Field Day rules for definitions. 6. Check all power sources used: If you used more than one source, check all that apply. 7. Your ARRL / RAC section: This is usually your State or Province, but if you live in one of the 8 US states that have multiple ARRL sections (California, Florida, Massachusetts, New Jersey, New York, Pennsylvania, Texas and Washington) refer to the ARRL section list. 8. Total number of CW QSOs: In the first blank list the number of raw non-dupe CW QSOs. Multiply the CW QSO total by 2 and enter the CW QSO point total in the second blank. Do not add the power multiplier in this field. 9. Total number of Digital QSOs: On the first blank list the number of raw non-dupe Digital QSOs. Multiply the Digital QSO total by 2 and enter the QSO point total in the second blank. Do not add the power multiplier in this field. 10. Total number of Phone QSOs: In the first blank list the number of raw non-dupe Phone QSOs. Multiply the Phone QSO total by 1 and enter the Phone QSO point total in the second blank. Do not add the power multiplier in this Field. 11. Total QSO Points: Add the CW, Digital and Phone QSO points and enter here. 12. Power Multiplier: Select the category that corresponds with your power multiplier. (Remember that to use the multiplier of 5, you must be running 5 watts or less and running battery power.) 13. Enter the power multiplier from Item 12 onto this line. 14. Multiply line 11 times line 13 to calculate your claimed score, exclusive of bonus points. 15. Bonus Points Claimed: Check each box for which you are claiming the earned Field Day bonus points. You must submit proof of each bonus points claimed or they will be disallowed. Proof for each may be in the form of photographs, copies of visitor logs, copies of press releases issued or newspaper articles printed, marked log excerpts showing Satellite and Natural power QSOs. A written statement signed by a club or group official will suffice for the Emergency Power, Public Place, Information Booth, and Site Visit bonuses. You must provide serviced copies of any messages claimed for bonus credit. A copy of the W1AW bulletin must be included with the entry submission. 16. A club officer, authorized club representative or individual must date, and sign the Summary Sheet. Please provide a mailing address and E-Mail address (if available) in case questions arise with the entry. 17. You must include a band and mode breakdown of QSOs on the reverse side of the summary sheet form. GOTA station contacts should be indicated on a single line. 18. The list of GOTA station operators and participants must be shown in order to claim the GOTA QSOs for credit or bonus. After completing the Summary Sheet, please enclose it, copies of Dupe Sheets (by band and mode), all proofs of bonus points claimed and mail to: Field Day Entry ARRL 225 Main Street Newington, CT 06111 All Field Day entries must be postmarked or E-mailed within 30 days after the contest or they will be ineligible for inclusion in the Field Day report.