[BACK]

GREEK LIGHTHOUSES AWARD

APPLICATION FORM

CALL SIGN:

Please accept my application and send the award to:

CLASS:

Name:

ENCLOSED:

Address:

Country:

 No
LIGHTHOUSE NAME
CALL
DATE
MODE
BAND
UTC
ARLHS No#
1.  
2.  
3.  
4.  
5.  
6.  
7.  
8.  
9.  
10.  
11.  
12.  
13.  
14.  
15.  

The QSL cards for the contacts have been checked and are certified to be correct by the following Radio Amateurs:

CALL1

SIGNATURE1

CALL2

SIGNATURE2

I declare that all credits pertaining to this award have been obtained in accordance with the rules for the award as well as the rules and regulations for radio amateur in my country.

DATE:

CALL:

SIGNATURE:

PLS DON'T WRITE HERE…..NOTES FOR AWARD MANAGER

DATE:

CHECKED:

CLASSES:

VERIFIED:

[BACK]