COUNTIES AWARD APPLICATION

Date:                                                                 Basic Award: #                                       Up Grade to:                #         

Name:                                                                                                                                                                          

Address:                                                             City:                                        State:               Zip Code:                    

Country:                                                                                                                                                                       

Call:                                                       10-10 #:                                                Expiration:                                           

Ex-Calls (optional):                                  E-Mail Address (optional):                                                                                 

**NOTE: Each Counties application must contain exactly 100 contacts. List each contact on a separate line and alphabetically by state and then by county. QSL confirmation is NOT required.

Have you included a copy of your Membership Card, $2.00 US & $3.00 DX for Basic, SASE US & $1.00 DX for upgrades Thank you for your participation in the 10-10 Award Program.

Mail To:
COUNTIES AWARD MANAGER
Brad Kimble - KØDBK #55192
3855 66th Street,
Iver Grove Heights, MN 55076-2222

E-mail k0dbk@comcast.net

Effective - January 1, 2000

County #	Call Sign	Ten-Ten #	Name	County	Date
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

 

County #	Call Sign	Ten-Ten #	Name	County	Date
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50

 

County #	Call Sign	Ten-Ten #	Name	County	Date
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75

 

County #	Call Sign	Ten-Ten #	Name	County	Date
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100

Just in Case

County #	Call Sign	Ten-Ten #	Name	County	Date
Spare
Spare