AMATEUR RADIO LICENCE APPLICATION
1. Complete in triplicate. Please ensure accuracy and legibility. One copy will be signed, stamped and returned to the applicant by the telecommunications division to serve as a temporary licence for a period not exceeding 120 days from the approval date.
2. An operators licence is subject to an annual renewal fee due by January 7th each year. Failure to pay such fee will render the licence invalid.
3. Each amateur station is to be licenced separately as this licence is only to operate not to own an amateur radio station.
4. Sections (4) and (5) on the reverse of this form apply only to non-St. Lucian citizens.
5. Sections (8), (9) and (10) on the reverse of this form apply only to an applicant who is a licenced amateur.
6. Completed forms are to be submitted to the Wireless Officer, Ministry of Communications, Works and Transport.
7. A list containing the serial nos. model nos. of all amateur radio equipment in your possession as well as a copy of your last licence payment receipt must be attached to this form.
8. Two classes of licence exist; novice class and general class. Novice class operators are restricted to the following amateur bands: a) 2 meters, b) 10 meters, c) 40 meters, and d) 80 meters. General class operators have all amateur previleges.
PLEASE TYPE OR PRINT
1. Name of applicant (surname, given names) ________________________________________________________________________________________
2. Address (street, P.O.Box, city, town or village, country, tel. no.)
________________________________________________________________________________________
________________________________________________________________________________________
3. Place and date of birth, nationality
________________________________________________________________________________________
4. St. Lucian resident? Yes ________ No ________ (if yes documentry proof needed)
5. Frequency of visits to St. Lucia ________ Annual ________ Occasional
6. Identification number (only one of the following nos. is required)
Passport no. / I.D. card no. / Drivers license no. _____________________________
7. Class of licence being applied for novice ________ general ________
8. Class of licence already had ________________________
9. Call sign __________________________
10. Date and place of issue ________________________________________________________
I certify that the statements made in this application are true, complete and correct, to the best of my knowledge
__________________________________________________________________________________
Date and signature of applicant
OFFICIAL USE ONLY