Samuel Clemens Chapter On-Line Upgrade Page

Samuel Clemens Chapter

Sam Clemens Electronic Upgrade Application



PLEASE READ:
Please do NOT use the ENTER key on your computer when filling in these fields. Doing so will send the form to me with all remaining fields left BLANK! I receive more incomplete forms than anything else for this one reason. Please use either your TAB key or simply click with your left mouse button on the next field you wish to fill in.

Also, there are automatically calculated fields on this form to give you an idea of what your upgrade points will be. You can not enter data in these fields, and it will be removed automatically when you submit the form. Automatically calculated fields can be identified by the light yellow background they have.

This form is to be used for S.C. upgrades only by those WITHOUT their Connecticut Yankee Seal!


Name: First> Last>
Address >
City > State >
Country > Zip >

Callsign > 10-10 # > Expiration Date - MM/YY>


Please enter ALL upgrade information!
Incomplete forms will not be processed!


Upgrade Date
My Basic Certif #
Current 'On-Air' Points

Number of Seals Collected:
New Conn Yank
New 1K Num
New Oak Ridge
New Worchester
Previous
New

Specials Claimed Information:
Specials
Description of special

Member Code Information:
New Members Worked Total Points
CH Codes
CS Codes
CM Codes
HC Codes
HL Codes
HM Codes
FS Codes
FC Codes
FP Codes
DX Codes
All Others

Points Collected:
Old Collected Total
New Points Collected
New Banked Points

Upgrade Recap:
Points from Seals
Points from Specials
Member Points This Upgrade
Points Earned This UG
Previous 'On-Air' Points
New 'On-Air' Point Value
New Banked Points


Email > Publish in chapter database? YesNo
Your website > Publish in chapter database? YesNo


For your records, click on your browsers print button before you submit your upgrade.

   


Back to the Samuel Clemens home page

© 2000 Samuel Clemens Chapter