60�PARALELL NORTH AWARD

                                                                            60�Paralell North Award                                                                       

      Application

Name_____________________________________________________________________________ 

{As you would like it to appear on award}

Address___________________________________________________________________________

Postal code_________________________ City____________________________________________

Country____________________________________________________________________________

Phone____________________ EMail____________________ CALLSIGN______________________

Log

|  STATION        |      DATE   |       TIME UTC  |    BAND   |  MODE   |    RST  |                    QTH             | 

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I certify, on my honor, that have observed all regulations established for amateur radio in my country as well

as the award rules. 

                                                                                _______________________________________

                                                                                                           Operator

We certify, that all QSL's have been checked and found true and correct in accordance with log.

                                                                               ________________________________________

                                                                                                     Two  Names and Callsigns

                                                                                                 Award Manager Representative

Cost of the award � 5,00 or 10 IRC�s  is $12 US
all applicants.

Send application, prefix list, certification statement, and payment to:

Manuel Alberto C. Marques (CT1BWW)
P.O. Box  41
2781-901 OEIRAS
PORTUGAL

E-Mail � ct1bww @ cwhamradio.com

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