Name
Callsign
Age
Email
Province	Alberta British-Colombia Saskatchewan Manitoba Ontario Quebec P.E.I Newfoundland Nova-Scotia New Brunswick Yukon N.W.T.
City
Street Adresse
Postal Code
Phone number
Qualification	Basic Basic + 5 wpm Basic + 12 wpm Advanced Advanced + 5 wpm Advanced + 12 wpm
would you like to become a provincial director	Yes No
Would you like to be HF Net Control ?	Yes No
extra info